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10.09.51.00.htm 10.09.51.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 51 Audiology Services Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.51.01.htm 10.09.51.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “Audiologist” means a professional who is licensed in accordance with Regulation .02 of this chapter who treats hearing disorders and communication problems.2) “Audiology assessment” means procedures performed by an audiologist to evaluate and monitor the status of the peripheral auditory system, auditory nerve, and central auditory system, or to establis
10.09.51.02.htm 10.09.51.02. 02 Licensure Requirements.. A. In order to provide services as an audiologist under this chapter, an audiologist shall be licensed by the State Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists to practice audiology, as defined in Health Occupations Article, Title 2, Annotated Code of Maryland, or by the appropriate licensing body in the jurisdiction in which the audiology services are performed.B. In order to provide se
10.09.51.03.htm 10.09.51.03. 03 Conditions for Participation.. A. A provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.. B. Specific requirements for participation in the Program as an audiologist, audiology center or group, or hearing aid dispenser are that the provider:1) Shall meet the licensure requirements in accordance with Regulation .02 of this chapter; and. 2) May not knowingly employ another person to provide services to Maryland Medical Assistance Progra
10.09.51.04.htm 10.09.51.04. 04 Covered Services.. The Program covers the following medically necessary services:. A. Audiology services, as follows:. 1) For participants who are at risk for or have a hearing impairment, audiology assessments using procedures appropriate for the participant’s developmental age and abilities; and2) Hearing aid evaluations and routine follow-up for participants with an identified hearing impairment, who currently use or are being considered for hearing aids; and
10.09.51.05.htm 10.09.51.05. 05 Limitations.. A. Covered audiology services, including hearing aids, cochlear implants, and auditory osseointegrated devices are limited to:1) Unless the time limitation is waived by the Program, one audiology assessment per year;. 2) The initial coverage of unilateral or bilateral hearing aids, cochlear implants, or auditory osseointegrated devices when the Department’s medical necessity criteria have been met;3) Replacement of unilateral or bilateral hearing
10.09.51.06.htm 10.09.51.06. 06 Preauthorization Requirements.. A. The Department requires preauthorization for the following services:. 1) All hearing aids;. 2) Certain hearing aid accessories;. 3) All cochlear implant devices and replacement components except microphone, transmitter cables, and transmitting coils;4) All auditory osseointegrated devices; and. 5) Repairs for hearing aids, cochlear implants, and auditory osseointegrated components exceeding $500.B. Preauthorization is valid:.
10.09.51.07.htm 10.09.51.07. 07 Payment Procedures.. A. To obtain compensation from the Department for covered services, the provider shall submit a request for payment using the format designated by the Department.B. Audiology services are reimbursed in accordance with COMAR 10.09.23.01-1.. C. The provider shall be paid the lesser of:. 1) The provider’s customary charge to the general public, unless the service is free to individuals not covered by Medicaid; or
10.09.51.08.htm 10.09.51.08. 08 Recovery and Reimbursement.. Recovery and reimbursement requirements are as set forth in COMAR 10.09.36.07..
10.09.51.09.htm 10.09.51.09. 09 Cause for Suspension or Removal and Imposition of Sanctions.. Cause for suspension or removal and imposition of sanctions is as set forth in COMAR 10.09.36.08..
10.09.51.10.htm 10.09.51.10. 10 Appeal Procedures.. Appeal procedures are as set forth in COMAR 10.09.36.09..
10.09.51.11.htm 10.09.51.11. 11 Interpretation of State Regulations.. State regulations are interpreted as set forth in COMAR 10.09.36.10..
10.09.51.9999.htm 10.09.51.9999. Administrative History Effective date: August 16, 1993 (20:16 Md. R. 1277) ―. Chapter revised effective June 21, 2004 (31:12 Md. R. 911). Regulation .01B amended effective July 18, 2005 (32:14 Md. R. 1275) January 16, 2006 (33:1 Md. R. 36) October 22, 2018 (45:21 Md. R. 973)Regulation .02A amended effective January 16, 2006 (33:1 Md. R. 36) October 22, 2018 (45:21 Md. R. 973)Regulation .03 repealed and new Regulation .03 adopted effective October 22, 2018 (45:21 Md. R. 973).
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