Sec. 10.09.01.05. Limitations  


Latest version.
  • 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 patient’s 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.