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<regulation prefix="Regulation" num=".02" citation="COMAR 31.12.08.02" title_num="31" subtitle_num="12" chapter_num="08" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Berenson-Eggers Type of Service Code” has the meaning stated in Health-General Article, §19-710.1, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“CPT code” means the Current Procedural Terminology Code maintained and distributed by the American Medical Association, including its codes and modifiers, and codes for anesthesia services.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Enrollee” has the meaning stated in Health-General Article, §19-710.1, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Evaluation and management services” has the meaning stated in Health-General Article, §19-710.1, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Geographic area” means each geographic area as published by the Centers for Medicare and Medicaid Services.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“HCPCS” means the Healthcare Common Procedure Coding System, a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology and other services such as ambulance services, prosthetic devices, other supplies, and non-physician services that are not covered by CPT codes but are recognized and maintained by the Centers for Medicare and Medicaid Services.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Health maintenance organization” has the meaning stated in Health-General Article, §19-701, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Medicare Economic Index” has the meaning stated in Health-General Article, §19-710.1, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Nonparticipating provider” means a provider other than a hospital or trauma physician who is not included on the provider panel of a health maintenance organization.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Participating provider” means a provider other than a hospital or trauma physician who is included on the provider panel of a health maintenance organization.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Provider” means a health care practitioner licensed, certified, or otherwise authorized by law to provide health care services.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Provider panel” has the meaning stated in Insurance Article, §15-112, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Reference year” means, for services provided in a particular calendar year, the period beginning with July 1 of the second previous calendar year through June 30 of the previous calendar year.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Similarly licensed provider” has the meaning stated in Health-General Article, §19-710.1, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Trauma physician” has the meaning stated in Health-General Article, §19-710.1, Annotated Code of Maryland.</text>
    </paragraph>
  </paragraph>
</regulation>