Sec. 10.09.53.07. Payment Procedures

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A. Payment procedures are as set forth in COMAR 10.09.36.04 and .06.

B. Payments.

(1) Payments shall be made directly to a qualified provider.

(2) Providers shall be paid the lesser of:

(a) The providers customary charge to the general public unless the service is free to individuals not covered by Medicaid; or

(b) The rate established according to the fee schedule published by the Department.

C. Rates.

(1) The Department shall publish a fee schedule for services covered under this chapter that shall be publicly available and updated at least annually or upon any changes made by the Department.

(2) Effective July 1, 2018, the Programs rates as specified in the Departments fee schedule shall increase on July 1 of each year by 3 percent, subject to the limitations of the State budget.

D. The nursing services provider shall identify the individual who ordered the nursing services by recording the individual practitioners National Provider Identifier (NPI) number on the claim.

                    
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