Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 2. |
Subtitle 09. MEDICAL CARE PROGRAMS |
Chapter 10.09.01. Advanced Practice Nurse Services |
Sec. 10.09.01.05. Limitations
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Under this chapter, the Program does not cover the following:
A. Services not medically necessary;
B. Services prohibited by the Maryland Nurse Practice Act or by the Board;
C. Advanced practice nursing services included as part of the cost of:
(1) An inpatient facility;
(2) A hospital outpatient department; or
(3) A freestanding clinic;
D. Visits by or to the provider solely for the purpose of the following:
(1) Prescription, drug, or food supplement pick-up;
(2) Recording of an electrocardiogram;
(3) Ascertaining the patients weight;
(4) Interpretation of laboratory tests or panels; or
(5) Prescribing or administering medication;
E. Drugs and supplies which are acquired by the provider at no cost;
F. Injections and visits solely for the administration of injections, unless medical necessity and the patient's inability to take oral medications are documented in the patient's medical record;
G. Services paid under the free-standing dialysis program as described in COMAR 10.09.22;
H. Immunizations required for travel outside the continental United States;
I. Prescriptions and injections for central nervous system stimulants and anorectic agents when used for weight control;
J. Acupuncture;
K. Hypnosis;
L. Travel expenses;
M. Investigational or experimental drugs and procedures;
N. Services denied by Medicare as not medically justified;
O. Specimen collection, except by venipuncture and capillary or arterial puncture, as a separate service;
P. Laboratory or X-ray services performed by another facility, which shall be billed to the Program directly by the facility; and
Q. For certified nurse midwives, a separate visit charge on date of delivery.