<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".14" citation="COMAR 10.09.54.14" title_num="10" subtitle_num="09" chapter_num="54" heading="Covered Services — Behavior Consultation Services.">
  <paragraph num="A.">
    <text>A provider may bill for the length of a home visit to a participant, upon completion of the services specified in §C of this regulation.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Behavior consultation services may be preauthorized by a participant's plan of service when:</text>
    <paragraph num="(1)">
      <text>A participant or the participant's representative request the service due to an identified behavioral issue; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The participant's behavior is:</text>
      <paragraph num="(a)">
        <text>Potentially dangerous to the participant's or another person's health and functioning; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Placing the participant at risk of institutionalization due to health and safety concerns.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Behavior consultation services include a:</text>
    <paragraph num="(1)">
      <text>Home visit by an individual qualified to render services to:</text>
      <paragraph num="(a)">
        <text>Evaluate a participant's behavior;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Assess the situation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Determine the contributing factors; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Recommend interventions and treatments; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Written report with the results of the provider’s assessment and recommendations, which shall be reviewed verbally by the participant, the participant’s representative and family when applicable, and the participant’s case manager and caregivers, which may include an assisted living provider, to discuss:</text>
      <paragraph num="(a)">
        <text>The report's findings and recommendations; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A course of action, including any related needed medical interventions.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Behavior consultation services do not include:</text>
    <paragraph num="(1)">
      <text>The time spent on related activities before or after the home visit; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The provider's time spent on any supervisory or consultative services provided to the renderer of services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The initial assessment provided in §C of this regulation to evaluate a participant's behavior, assess the situation, and determine the contributing factors shall be performed in person.</text>
  </paragraph>
  <paragraph num="F.">
    <text>The verbal review described in §C(2) of this regulation may be delivered via telehealth if recommendations do not require hands-on training or intervention.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Except as provided in §§E and F of this regulation, behavior consultation services may be rendered via telehealth.</text>
  </paragraph>
</regulation>