# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 76 — School-Based Health Centers (SBHC)

#### Regulation .06 Reimbursement Methodology.

*COMAR 10.09.76.06*

A. The provider shall charge the Program the provider’s customary charge to the general public for similar services and charge the provider’s acquisition cost for injectable drugs or dispensed medical supplies.

B. If the service is free to individuals not covered by Medicaid:

  (1) The provider:

    (a) May charge the Program; and

    (b) Shall be reimbursed in accordance with §B of this regulation; and

  (2) The provider’s reimbursement is not limited to the provider’s customary charge.

C. Local health department clinics, general clinics, physicians, and nurse practitioners shall be paid the lesser of:

  (1) The provider’s customary charge to the general public unless the service is free to individuals not covered by Medicaid; or

  (2) The maximum rates according to COMAR 10.09.02.07.

D. The Department shall reimburse an SBHC, sponsored by an LHD or general clinic, for dental services in accordance with COMAR 10.09.05.07.

E. The Department shall reimburse an SBHC, sponsored by an LHD, general clinic, nurse practitioner, or physician, for specialty behavioral health services in accordance with COMAR 10.21.25 and 10.09.80.08.

F. The Department shall reimburse an SBHC, sponsored by an FQHC, for services in accordance with COMAR 10.09.08.08.