<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.09.76.06" title_num="10" subtitle_num="09" chapter_num="76" heading="Reimbursement Methodology.">
  <paragraph num="A.">
    <text>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.</text>
  </paragraph>
  <paragraph num="B.">
    <text>If the service is free to individuals not covered by Medicaid:</text>
    <paragraph num="(1)">
      <text>The provider:</text>
      <paragraph num="(a)">
        <text>May charge the Program; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Shall be reimbursed in accordance with §B of this regulation; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The provider’s reimbursement is not limited to the provider’s customary charge.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Local health department clinics, general clinics, physicians, and nurse practitioners shall be paid the lesser of:</text>
    <paragraph num="(1)">
      <text>The provider’s customary charge to the general public unless the service is free to individuals not covered by Medicaid; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The maximum rates according to COMAR 10.09.02.07.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The Department shall reimburse an SBHC, sponsored by an LHD or general clinic, for dental services in accordance with COMAR 10.09.05.07.</text>
  </paragraph>
  <paragraph num="E.">
    <text>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.</text>
  </paragraph>
  <paragraph num="F.">
    <text>The Department shall reimburse an SBHC, sponsored by an FQHC, for services in accordance with COMAR 10.09.08.08.</text>
  </paragraph>
</regulation>