Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.59 - Specialty Mental Health Services
Section 10.09.59.08 - Authorization Requirements

Universal Citation: MD Code Reg 10.09.59.08

Current through Register Vol. 51, No. 19, September 20, 2024

A. The ASO shall establish a process, through a utilization review system, for authorization of specialty mental health services.

B. The ASO shall authorize services that are:

(1) Medically necessary;

(2) Of a type, frequency, and duration that are consistent with expected results and cost-effective; and

(3) Delivered in a manner consistent with this chapter.

C. Preauthorization is not required before a provider renders services in an emergency department.

D. Except as provided in Regulation .08C of this chapter, no payment shall be rendered for services that have not been authorized.

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