Chiropractic services are covered for REM participants when: Services are provided to a REM participant who is 21 years old or older; Services are provided by a physician or chiropractor; The qualifying REM diagnosis or related illness shows deterioration or worsening symptoms and other traditional treatments have been ineffective; The treatment enhances or restores the participant's level of functioning; or Symptoms resulting from the REM diagnosis or related illness impairs a participant's activities of daily living. Dental services are covered when services are: Provided to a REM participant who is 21 years old or older; and Rendered as specified in COMAR 10.09.05. Nutritional counseling services are covered when services are provided: To a REM participant who is 21 years old or older; and By a dietitian-nutritionist. Nutritional supplements are covered when the services: Include nutritional supplements or enteral feeding when medically necessary other than those administered by tube; and Are as described in COMAR 10.09.03. The Department shall cover a physician's, physician assistant’s, or nurse practitioner’s participation at interdisciplinary team meetings when the case manager, in conjunction with the team or specific team members, convenes the team meeting for the purpose of developing or reviewing the REM participant's plan of care to ensure continuity of care or access to a specific service. Occupational therapy services are covered when services are provided: To a REM participant who is 21 years old or older; By an occupational therapist; and In accordance with COMAR 10.46.01 and 10.46.02. Speech-language pathology services include only those services that are provided: To a REM participant who is 21 years old or older; By a speech-language pathologist; and In accordance with COMAR 10.41.02 and 10.41.03.