Regulation .05 Limitations.
Regulation .05 Limitations.LinkCopy Citation
Under this chapter, the Program does not cover the following:
A.
Services not specified in Regulation .03 of this chapter;
B.
Services not medically necessary;
C.
Services prohibited by the Maryland Nurse Practice Act or by the State Board of Nursing;
D.
Advanced practice nursing services included as part of the cost of:
(1)
An inpatient facility;
(2)
A hospital outpatient department; or
(3)
A freestanding clinic;
E.
Visits by or to the provider solely for the purpose of the following:
(1)
Prescription, drug, or food supplement pick-up;
(2)
Recording of an electrocardiogram;
(3)
Ascertaining the patient’s weight;
(4)
Interpretation of laboratory tests or panels; or
(5)
Prescribing or administering medication;
F.
Drugs and supplies which are acquired by the provider at no cost;
G.
Services paid under the free-standing dialysis program as described in COMAR 10.09.22;
H.
Prescriptions and injections for central nervous system stimulants and anorectic agents when used for weight control;
I.
Acupuncture;
J.
Hypnosis;
K.
Travel expenses;
L.
Investigational or experimental drugs and procedures;
M.
Services denied by Medicare as not medically justified;
N.
Specimen collection, except by venipuncture and capillary or arterial puncture, as a separate service;
O.
Laboratory or X-ray services performed by another facility, which shall be billed to the Program directly by the facility; and
P.
For certified nurse midwives, a separate visit charge on date of delivery.