Regulation .05 Limitations.

Services not encompassed by the physician assistant’s written delegation agreement with the physician, if required by the state in which services are provided;

Services not medically necessary;

Services prohibited by the Board;

Services prohibited in the state in which services are provided;

Physician assistant services included as part of the cost of an inpatient facility, hospital outpatient department, or freestanding clinic;

Visits by or to the physician assistant solely for the purpose of the following:

Drugs and supplies which are acquired by the licensed and certified physician assistant at no cost;

Injections and visits solely for the administration of injections, unless medical necessity and the patient's inability to take appropriate oral medications are documented in the patient's medical record;

More than one visit per day per participant unless adequately documented as an emergency situation;

Services paid under the free-standing dialysis program described in COMAR 10.09.22;

Physician assistant billings for those laboratory or X-ray services performed by another facility, which shall bill the Program directly;

Immunizations required for travel outside the continental United States;

Acupuncture;

Hypnosis;

Travel expenses;

Prescriptions and injections for central nervous system stimulants and anoretic agents when used for weight control;

Investigational or experimental drugs and procedures;

Services denied by Medicare as not medically justified; and

Services for which the patient specifically requests to see a physician.