Sec. 10.09.40.06. Payment Procedures

A. Request for Payment.

(1) Requests for payment of early intervention services case management shall be submitted by an approved provider according to procedures established by the Department. The Department reserves the right to return to the provider, before payment, all invoices not properly signed and completed.

(2) A provider shall submit a request for payment on the invoice form designated by the Department. A separate invoice shall be submitted for each participant.

(3) The completed invoice form in §A(2), of this regulation, shall indicate the:

(a) Date or dates of service;

(b) Participant's name and Medical Assistance number;

(c) Provider's name, location, and provider number; and

(d) Nature, unit or units, and procedure code or codes of covered services provided.

(4) Providers shall bill the Program for the appropriate fee specified in §C of this regulation.

(5) The Program may not make direct payment to recipients.

B. Billing Time Limitations. Billing time limitations shall be as set forth in COMAR 10.09.36.06.

C. Payment shall be made:

(1) Only to a qualified provider for covered services rendered to a participant, as specified in these regulations;

(2) Only to one provider of early intervention services case management rendered to a participant during a billing period; and

(3) According to the following fee-for-service schedule for early intervention services case management:

Description Fee Per Unit of Service

(a) Initial case management (only one unit of service may be reimbursed per participant) ------------------- $500,

(b) Ongoing case management (only one unit of service per month may be reimbursed for a participant after completion of initial case management or the annual IFSP review) ----------- $150,

(c) Annual IFSP review (only one unit of service may be reimbursed for a participant annually, for a total of two units per participant) ----------------------- $275.