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10.09.70.00.htm 10.09.70.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 09 MEDICAL CARE PROGRAMS Chapter 70 Maryland Medicaid Managed Care Program: Non-Capitated Covered Services Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.70.01.htm 10.09.70.01. 01 Scope.. This chapter describes the services that are not the responsibility of the MCOs but are covered by the Department on a fee-for-service basis.
10.09.70.02.htm 10.09.70.02. 02 Behavioral Health Non-Capitated Covered Services.. A. An MCO is not responsible for reimbursing for the following substance use disorder services, regardless of diagnosis:1) Services delivered by a community-based provider as described in COMAR 10.09.80 with the following procedure codes:H0001. Alcohol/drug assessment. H0004. Alcohol/drug individual counseling and therapy. H0005. Alcohol/drug group counseling. H0014. Alcohol and/or drug services; ambulatory detoxification.
10.09.70.03.htm 10.09.70.03. 03 Non Behavioral Health Fee-For-Service Benefits.. An MCO may not be required to provide any of the following benefits or services that are reimbursed directly by the Department:A. The remaining days of a hospital admission following enrollment in the MCO if the recipient was admitted to the hospital before the date of the recipient’s enrollment;B. Long-term care services except for those outlined in COMAR 10.09.67.07B and COMAR 10.09.67.12A;. C. Intermediate Care Faci
10.09.70.9999.htm 10.09.70.9999. Administrative History Effective date:. Regulations .01―11 adopted as an emergency provision effective November 8, 1996 (23:25 Md. R. 1730) adopted permanently effective March 10, 1997 (24:5 Md. R. 408)Regulation .01 amended effective December 23, 2002 (29:25 Md. R. 1981). Regulation .02C, D amended effective December 23, 2002 (29:25 Md. R. 1981). Regulation .05B amended effective December 23, 2002 (29:25 Md. R. 1981). Regulation .06B amended effective October 14, 2013
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