# COMAR Title 10 — Maryland Department of Health

## Subtitle 14 — Cancer Control

### Chapter 02 — Reimbursement for Breast and Cervical Cancer Diagnosis and Treatment

#### Regulation .15 Medical Management Fee.

*COMAR 10.14.02.15*

A. A participating health care provider eligible to receive a medical management fee may be one of the following:

  (1) Anesthesiologist;

  (2) Certified nurse midwife;

  (3) Family practitioner;

  (4) Gynecologist;

  (5) Medical internist;

  (6) Medical oncologist;

  (7) Nurse anesthetist;

  (8) Nurse practitioner;

  (9) Pathologist;

  (10) Physician assistant;

  (11) Radiation oncologist;

  (12) Radiologist;

  (13) Surgeon; and

  (14) Participating health care provider who renders services pursuant to §B of this regulation.

B. The Department shall reimburse a participating health care provider as outlined in §A of this regulation a medical management fee of $50 each time a reimbursed service:

  (1) Is in compliance with the medical guidelines pursuant to Regulation .04A(7)(a)—(f) of this chapter;

  (2) Involves a consult with an oncologist pursuant to Regulation .04A(7)(g) and (h) of this chapter;

  (3) Is in compliance with the medical care management guidelines pursuant to Regulation .04A(6) of this chapter; or

  (4) Is billed with the medical management fee for reporting and includes a copy of the relevant medical report including, but not limited to:

    (a) Radiology;

    (b) Biopsy;

    (c) Operative; or

    (d) Staging.

C. The Program shall reimburse for claims pursuant to this regulation as set forth in Regulation .21 of this chapter.