Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.23 - Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services
Section 10.09.23.08 - Recovery and Reimbursement
Universal Citation: MD Code Reg 10.09.23.08
Current through Register Vol. 51, No. 19, September 20, 2024
A. Regardless of whether the participant has other third-party insurance coverage, EPSDT screening providers shall bill the Program directly for the following components of an EPSDT screen:
(1)
Comprehensive unclothed physical examinations;
(2) Immunizations when the vaccine is not
covered by the Vaccines for Children Program;
(3) Vaccine administration; and
(4) Objective screenings for:
(a) Developmental assessment;
(b) Hearing; and
(c) Vision.
B. Upon submission of a claim for a EPSDT screening component, as described in §A of this regulation, the Department shall pursue third-party reimbursement when appropriate.
C. Recovery and reimbursement for all other services in the chapter are set forth in COMAR 10.09.36.07A.
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