Skip to Main Content
<< Back | Return to Main COMAR Search Page

12 records match your request.

FileAbstract
10.09.87.00.htm 10.09.87.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 09 MEDICAL CARE PROGRAMS Chapter 87 Free-Standing Independent Diagnostic Testing Facilities Authority: Health-General Article, §2-104(b) 15-103, and 15-105, Annotated Code of Maryland
10.09.87.01.htm 10.09.87.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “CMS” means Centers for Medicare and Medicaid Services.. 2) "Department" means Maryland Department of Health.. 3) "Independent Diagnostic Testing Facility (IDTF) means a fixed location or mobile entity independent of a hospital or physician’s office where diagnostic services are performed by licensed certified non-physician personnel under appropriate physician supervision.
10.09.87.02.htm 10.09.87.02. 02 License Requirements.. A. The provider shall meet all license requirements as set forth in COMAR 10.09.36.02.. B. A facility or mobile unit that is operating radiological equipment shall be licensed or certified and registered by the Department of the Environment in accordance with COMAR 26.12.01 through COMAR 26.12.03.C. A facility that performs mammography services shall be certified by the Food and Drug Administration (FDA)D. A facility operating major medical equipment sh
10.09.87.03.htm 10.09.87.03. 03 Conditions for Participation.. A. General requirements for participation in the Program are that a provider shall meet all conditions for participation as set forth in COMAR 10.09.36.03.B. Requirements for participation in the Program as an IDTF provider/mobile IDTF provider require that the provider:1) Be approved by Medicare to furnish diagnostic services in an IDTF;. 2) Meets the licensure requirements in accordance with Regulation .02 of this chapter; and.
10.09.87.04.htm 10.09.87.04. 04 Covered Services.. A. The Program covers medically necessary radiology services rendered to a recipient in an IDTF when the services are:1) Rendered in a CMS certified IDTF or an IDTF Mobile Unit;. 2) Provided according to the laws and regulations of the state and locality in which they are rendered;3) Rendered by a physician or supervised technician;. 4) Ordered in writing by the treating physician or non-physician practitioner in accordance with state law; and
10.09.87.05.htm 10.09.87.05. 05 Limitations.. The Program does not cover the following:. A. Services for which the IDTF provider cannot supply a properly completed order identifying by name, the authorized ordering practitioner;B. Services not adequately documented in the recipient’s medical record;. C. Services not medically necessary;. D. Procedures that are the provider as investigational or experimental in nature;. E. Services which are specifically included as an integral part of another service;.
10.09.87.06.htm 10.09.87.06. 06 Preauthorization Requirements. Reserved..
10.09.87.07.htm 10.09.87.07. 07 Payment Procedures.. A. General policies for payment that are applicable to all providers are set forth in COMAR 10.09.36.04.B. IDTF providers shall identify the ordering who authorized the diagnostic services by either:. 1) Recording the National Provider Identifier (NPI) number for the individual provider on the claim; or2) Recording the name and NPI of the authorized ordering provider on the invoice and attaching to the invoice a copy of the properly completed order t
10.09.87.08.htm 10.09.87.08. 08 Recovery and Reimbursement.. General policies governing recovery and reimbursement procedures that are applicable to all providers are set forth in COMAR 10.09.36.07.
10.09.87.09.htm 10.09.87.09. 09 Cause for Suspension or Removal and Imposition of Sanctions.. General policies governing the cause for suspension and removal and imposition of sanctions procedures that are applicable to all providers are set forth in COMAR 10.09.36.08.
10.09.87.10.htm 10.09.87.10. 10 Appeal Procedures.. General policies governing appeal procedures that are applicable to all providers are set forth in COMAR 10.09.36.09.
10.09.87.9999.htm 10.09.88.9999. Administrative History Effective date: April 28, 2014 (41:8 Md. R. 472). Regulation .07C, I amended effective July 4, 2016 (43:13 Md. R. 712). Regulation .07D amended effective February 27, 2017 (44:4 Md. R. 252).
<< Back | Return to Main COMAR Search Page