Md. Code Regs. 10.09.23.08

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.23.08 - Recovery and Reimbursement

A. Regardless of whether the participant has other third-party insurance coverage, EPSDT screening providers shall bill the Program directly for the following components of an EPSDT screen:

(1) Comprehensive unclothed physical examinations;

(2) Immunizations when the vaccine is not covered by the Vaccines for Children Program;

(3) Vaccine administration; and

(4) Objective screenings for:

(a) Developmental assessment;

(b) Hearing; and

(c) Vision.

B. Upon submission of a claim for a EPSDT screening component, as described in §A of this regulation, the Department shall pursue third-party reimbursement when appropriate.

C. Recovery and reimbursement for all other services in the chapter are set forth in COMAR 10.09.36.07A.

Md. Code Regs. 10.09.23.08

Regulation .08 amended effective March 20, 1989 (16:5 Md. R. 629)
Regulations .08 adopted effective September 10, 1984 (11:18 Md. R. 1584)
Regulation .08F amended as an emergency provision effective January 28, 1991 (18:3 Md. R. 301); emergency status expired April 8, 1991 (18:9 Md. R. 1004)
Regulations .08F,J amended as an emergency provision effective April 9, 1991 (18:9 Md. R. 1005); Regulation.08F,J amended permanently effective October 7, 1991 (18:18 Md. R. 2004) (Regulation .09A not amended permanently at this time_emergency status expired October 6, 1991)
Regulation .08I amended as an emergency provision effective July 1, 1990 (17:15 Md. R. 1850); amended permanently effective November 1, 1990 (17:20 Md. R. 2427)
Regulation .08J amended effective May 1, 1983 (10:8 Md. R. 725); February 13, 1984 (11:3 Md. R. 200); October 29, 1984 (11:21 Md. R. 1814); October 1, 1985 (12:19 Md. R. 1849)
Regulation .08J amended as an emergency provision effective July 1, 1984 (11:13 Md. R. 1170); emergency status expired October 28, 1984
Regulation .08J amended as an emergency provision effective October 1, 1986 (13:22 Md. R. 2393); adopted permanently effective February 9, 1987 (14:2 Md. R. 129)
Regulation .08L amended effective October 29, 1984 (11:21 Md. R. 1814)
Regulation .08 amended effective June 21, 2004 (31:12 Md. R. 911)
Regulations .08 adopted effective March 22, 2010 (37:6 Md. R. 477); amended effective 50:15 Md. R. 681, eff. 8/7/2023