Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.85 - Free-Standing Birth Centers
Section 10.09.85.06 - Payment Procedures

Universal Citation: MD Code Reg 10.09.85.06

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

A. The Program will reimburse free-standing birth centers for:

(1) A facility fee of $2,000 for the care of the delivering mother and delivery of the newborn, if the delivery takes place at the facility; and

(2) A facility fee of $500 for the care of the newborn.

B. If the mother is transferred to a hospital prior to delivering the newborn, the Department will reimburse as follows:

(1) If the mother was at the birth center for less than 2 hours, before the delivery of the newborn, the reimbursement will be at 25 percent of the Medicaid rate;

(2) If the mother was at the birth center for 2 to 5 hours, before the delivery of the newborn, the reimbursement will be at 50 percent of the Medicaid rate;

(3) If the mother was at the birth center for 5 to 8 hours, before to the delivery of the newborn, the reimbursement will be at 70 percent of the Medicaid rate; and

(4) If the mother was at the birth center for more than 8 hours, before the delivery of the newborn, the reimbursement will be at the full Medicaid rate.

C. The Program shall pay for covered services at the lower of the:

(1) Provider's customary charge to the general public; or

(2) The Program's fee.

D. The provider shall submit a request for payment as set forth in COMAR 10.09.36.04A.

E. The Program reserves the right to return to the provider, before payment, all invoices that are not properly completed.

F. The Program may not make a direct payment to a recipient.

G. Billing time limitations for claims submitted under this chapter are set forth in COMAR 10.09.36.06.

Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.