Sec. 10.09.90.18. Payment Procedures  


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  • A. The Program shall reimburse the provider according to the requirements in this chapter and COMAR 10.09.89 for services delivered to 1915(i) participants, and the fees established under COMAR 10.21.25.

    B. Request for Payment.

    (1) A provider shall submit requests for payment of mental health case management services according to procedures established by the Department.

    (2) A provider shall bill the Program for the appropriate fee under COMAR 10.21.25.

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

    C. Minutes of service and units per participant are to be totaled by day and by service.

    D. Billing time limitations for services covered under this chapter are the same as those set forth in COMAR 10.09.36.06.

    E. Payment shall be made:

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

    (2) According to the requirements of this chapter and COMAR 10.09.89 for 1915(i) participants, and the fees established in COMAR 10.21.25.

    F. Service Provision. Units of services for all levels of care coordination shall be 15 minutes of contact, which may include:

    (1) Face-to-face and non-face-to-face contacts with the participant or, if the participant is a minor, with the minor’s parent or guardian; and

    (2) Indirect collateral contacts on behalf of the participant with other community providers.