Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.14 - Vision Care Services
Section 10.09.14.07 - Payment Procedures
Current through Register Vol. 51, No. 19, September 20, 2024
A. Form for Request for Payment.
B. The Department reserves the right to return to the provider, before payment, all invoices not properly completed.
C. The provider shall charge the Program the provider's customary charge to the general public for similar professional services. If the service is free to individuals not covered by Medicaid:
D. The provider shall charge acquisition cost for eyeglass frames, eyeglass lenses, contact lenses, and other optical aids.
E. Vision care services are reimbursed according to COMAR 10.09.23.01-1.
F. The Department will pay professional fees for covered services at the lesser of:
G. The Department will pay for materials at acquisition costs not to exceed the maximums established by the Department.
H. Payments on Medicare claims are authorized if:
I. Supplemental payment on Medicare claims is made subject to the limitations of the State budget and the following provisions:
J. The provider may not bill the Department for:
K. The Department's payment for lenses, frames, case, fitting, and dispensing covers any routine follow-up and adjustments for 60 days, and no additional fees will be paid.
L. The Department will make no direct payment to the recipient.
M. Payment for contact lenses is made as follows:
N. Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.