<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.21.25.09" title_num="10" subtitle_num="21" chapter_num="25" heading="Fee Schedule — Support Services.">
  <paragraph num="A.">
    <text>Psychiatric Rehabilitation Program (PRP) Services. The Department shall reimburse a PRP for providing face-to-face rehabilitation services to an individual with a serious emotional disturbance (SED) or serious and persistent mental disorder (SPMD), by a monthly rate that is based on a minimum and maximum range of services, when the PRP submits monthly supporting encounter data after services are provided to the individual, within which the provider shall meet the needs of the individual, as follows:</text>
    <paragraph num="(1)">
      <text>Assessment ... $61.62;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>PRP services to an employed individual in a supported employment program, delivered at the job site, at a rate of $107.62 per month, for:</text>
      <paragraph num="(a)">
        <text>A minimum of two services per month;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A maximum of 30 services per month;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A minimum of 15 minutes per service; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A maximum of one service per day.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Additional PRP Services. In addition to the services outlined in §A of this regulation, the Department shall reimburse a PRP for providing face-to-face rehabilitation services to an individual with SED or SPMD by a monthly rate that is based on a minimum and maximum range of services, within which the provider shall meet the needs of the individual, as follows:</text>
    <paragraph num="(1)">
      <text>PRP Community Psychiatric Support Services delivered to an individual with an SED or an SPMD, whose functioning is severely impaired, and who is living with a parent, guardian, or relative who is legally responsible for the individual's care, as follows:</text>
      <paragraph num="(a)">
        <text>When on-site and off-site services are delivered to an individual by one PRP, $426.99 per month for:</text>
        <paragraph num="(i)">
          <text>A minimum of three and a maximum of 30 services per month, on-site or off-site;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>On-site services, at a minimum of 60 minutes per service;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Off-site services, at a minimum of 15 minutes per service; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A maximum of one on-site or one off-site service per day; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>When on-site and off-site services are delivered to an individual by two PRPs, a PRP may receive reimbursement for either on-site or off-site services, but not both, as follows:</text>
        <paragraph num="(i)">
          <text>On-site services, at a rate of $183.22 per month, for a minimum of two services and a maximum of 30 services per month, at a minimum of 60 minutes per service;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Off-site services, at a rate of $243.76 per month, for a minimum of two services and a maximum of 30 services per month, at a minimum of 15 minutes per service; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Limited to reimbursement for one on-site and one off-site service per day;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>PRP supported living for services delivered to an individual with an SED or an SPMD, whose functioning is severely impaired, and who is living independently or with individuals who are not legally responsible for their care, as follows:</text>
      <paragraph num="(a)">
        <text>When services are delivered to an individual by one PRP, $760.88 per month as follows:</text>
        <paragraph num="(i)">
          <text>A minimum of six and a maximum of 30 services per month, on-site or off-site;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>On-site services, at a minimum of 60 minutes per service;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Off-site services, at a minimum of 15 minutes per service; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Limited to one on-site and off-site service per day; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>When on-site and off-site services are delivered to an individual by two PRPs, a PRP may receive reimbursement for either on-site or off-site services, but not both, as follows:</text>
        <paragraph num="(i)">
          <text>On-site services, at a rate of $259.37 per month, for a minimum of three services and a maximum of 30 services per month, at a minimum of 60 minutes per service;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Off-site services, at a rate of $501.51 per month, for a minimum of five services and a maximum of 30 services per month and a minimum of 15 minutes per service; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Limited to reimbursement for one on-site or off-site service per day;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>PRP services delivered to individuals in residential rehabilitation programs (RRPs) as follows:</text>
      <paragraph num="(a)">
        <text>General support:</text>
        <paragraph num="(i)">
          <text>On-site, at a rate of $447.70 per month, for a minimum of four services, up to 30 services per month, at a minimum of 60 minutes per service;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Off-site, at a rate of $1,202.13 per month, for a minimum of 13 services, up to 30 services per month, at a minimum of 15 minutes per service; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Any combination of on-site or off-site PRP services, at a rate of $1,649.83 per month, for a minimum of 17 services, up to 30 services per month, at a minimum of 30 minutes per service; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Intensive support:</text>
        <paragraph num="(i)">
          <text>On-site, at a rate of $447.70 per month, for a minimum of four services, up to 30 services per month, at a minimum of 60 minutes per service;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Off-site, at a rate of $3,123.17 per month, for a minimum of 19 services, up to 30 services per month, at a minimum of 15 minutes per service; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Any combination of on-site or off-site PRP services, at a rate of $3,570.87 per month, for a minimum of 23 services, up to 30 services per month, at a minimum of 30 minutes per service; or</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>PRP services delivered to individuals when transitioning from inpatient level of care to the community, any combination of on-site or off-site PRP services, at a rate of $447.70 per month, for a minimum of 4 services, up to 30 services per month, at a minimum of 60 minutes per service.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>RRP Services. The Department shall reimburse an RRP for providing services to an individual with a serious and persistent mental disorder and whose functioning is severely impaired, as follows:</text>
    <paragraph num="(1)">
      <text>Room and board ... $12.59 per day;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A provider may collect additional fees from an individual not covered by the rate established in §B(1) of this regulation to cover a portion of costs of food, shelter, and other household expenses associated with an individual's basic needs in an RRP residence, not to exceed the provider's cost of care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Mental Health Vocational Programs (MHVP). The Department shall reimburse a program that is approved for mental health vocational services for providing supported employment services to an individual with a mental disorder:</text>
    <paragraph num="(1)">
      <text>If the service is authorized by the Administration or its designee;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the program documents an individual's application to the Division of Rehabilitation Services (DORS) and has documentation of the decision on the application; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>At the following rates, per individual approved for supported employment services:</text>
      <paragraph num="(a)">
        <text>Completion of vocational assessment, individual supported employment plan, referral to DORS, and education regarding entitlements and work incentives, not more than three times per year ... $430.49;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Job placement of the individual, not more than three times per year ... $1,075.14;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Intensive job coaching, if not otherwise reimbursed, at a maximum of $7.40 per 15 minutes, up to a lifetime maximum of $2,750 per individual; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Extended MHVP support ... $349.77 per month.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Mental Health Vocational Programs — Evidence-Based Programs. The Department shall reimburse an MHVP evidence-based program:</text>
    <paragraph num="(1)">
      <text>If the service is authorized by the Administration or its designee;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the program documents an individual's application to the Division of Rehabilitation Services (DORS) and has documentation of the decision on the application; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>At the following rates, per individual approved for supported employment services:</text>
      <paragraph num="(a)">
        <text>Completion of vocational assessment, individual supported employment plan, referral to DORS, and education regarding entitlements and work incentives not more than three times per year ... $430.49;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Job placement of the individual not more than three times per year ... $1,075.14;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Intensive job coaching, if not otherwise reimbursed, at a maximum of $7.40 per 15 minutes, up to a lifetime maximum of $2,750.00 per individual;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Clinical service coordination at a rate of $107.62 per month, that is documented and includes, with the individual's consent, at a minimum:</text>
        <paragraph num="(i)">
          <text>Monthly collaboration with the individual's treatment or psychiatric rehabilitation team; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Face-to-face contact every 6 months with the individual's treating clinician or psychiatrist; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>Extended PRP support to an individual in a supported employment program at a rate of $430.49 per month for:</text>
        <paragraph num="(i)">
          <text>A minimum of three services per month;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A maximum of 30 services per month;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A minimum of 15 minutes per service; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A maximum of one service per day.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Respite Care. The Department shall reimburse a program that is approved for respite care for providing services to a child or adolescent with a serious emotional disturbance, whose functioning is severely impaired, or an adult with a serious and persistent mental disorder, whose functioning is severely impaired, as follows:</text>
    <paragraph num="(1)">
      <text>For children:</text>
      <paragraph num="(a)">
        <text>General support in a facility ... $174.34 per day; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In-home respite, when the need for short-term, one-to-one support is documented or for in-home respite and approved by the CSA up to a maximum of 10 hours per day at a rate of ... $3.49 per 15 minutes;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>For adults, general support in a residential rehabilitation program ... $75.61 per day.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Enhanced Support. When the need for short-term, one-to-one support is documented and approved by the CSA, the Department shall reimburse an OMHC, PRP, RRP, or MTS for providing services to a child or adolescent with an SED or an adult with an SPMD, and whose functioning is seriously impaired, at the rate of $12.91 per hour up to a maximum of $129.10 per day, not to exceed 30 days per year.</text>
  </paragraph>
  <paragraph num="H.">
    <text>Therapeutic Behavioral Services. The Department shall reimburse a therapeutic behavioral services provider, as defined in COMAR 10.09.34, as follows:</text>
    <paragraph num="(1)">
      <text>One-to-one behavioral aide services to a child or adolescent ... $5.39 per 15 minutes;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Initial assessment and development of a behavioral plan ... $105.51;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Reassessment and development of a new behavioral plan ... $99.18.</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Adult Mental Health Case Management. The Department shall reimburse a designated program that is approved by the Core Service Agency for mental health case management according to COMAR 10.09.45 for providing case management services to an adult with a serious and persistent mental health disorder as follows:</text>
    <paragraph num="(1)">
      <text>Assessment ... $108.61;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Case Management Service units, for a minimum of 60 minutes of face-to-face and non-face-to-face case management service at a rate of $108.61 per day for:</text>
      <paragraph num="(a)">
        <text>General level up to 2 units per month; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Intensive level up to 5 units per month; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>When an individual is referred to case management by the Administration or its designee, and is transitioning from an institute for mental disease or hospital, one transitional visit at a rate of $159.55.</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>Mental Health Case Management: Care Coordination for Children and Youth. The Department shall reimburse a designated program that is approved by the Core Service Agency to provide mental health case management services to a child or adolescent with a serious emotional disorder, according to COMAR 10.09.90, as follows:</text>
    <paragraph num="(1)">
      <text>Case Management Service units, for a minimum of 15 minutes of face-to-face and non-face-to-face case management service at a rate of $20.19 per 15 minutes for:</text>
      <paragraph num="(a)">
        <text>Level I — General Coordination up to 12 units of service per month, with a minimum of two units of face-to-face contact;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Level II — Moderate Care Coordination up to 30 units of service per month, with a minimum of four units of face-to-face contact; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Level III — Intensive Care Coordination up to 60 units of service per month, with a minimum of six units of face-to-face contact; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>For comprehensive assessment and reassessment case management service units, for Level I and Level II only, four additional face-to-face units of service above the monthly maximum may be billed during the first month of service to the participant and every 6 months thereafter.</text>
    </paragraph>
  </paragraph>
</regulation>