Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.33 - Health Homes
Section 10.09.33.09 - Payment Procedures
Universal Citation: MD Code Reg 10.09.33.09
Current through Register Vol. 51, No. 19, September 20, 2024
A. The Department shall reimburse the health home for covered services according to the requirements in this chapter and the rate established in §C of this regulation.
B. Request for Payment.
(1) The health home provider is authorized to bill for the intake and ongoing monthly rate for a participant when:
(a) The participant is receiving PRP, MTS, or OTP services; and
(b) The intake portion of the participant's eMedicaid file has been submitted and initial services have been delivered.
(2) After completing the required health home service provision reporting in eMedicaid, the health home provider shall, within 30 days from the end of the month during which health home services were provided, submit a request for payment for all participants who received two health home services during that month.
(3) A health home provider shall bill the Department for the appropriate rate specified in §C of this regulation.
C. The Department shall reimburse according to the following fee schedule:
(1) For dates of service from July 1, 2022, through June 30, 2023, at a monthly rate of $127.21 per participant; and
(2) Effective July 1, 2023, at a monthly rate of $131.03 per participant.
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