Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.95 - Special Psychiatric Hospitals
Section 10.09.95.04 - Covered Services
Universal Citation: MD Code Reg 10.09.95.04
Current through Register Vol. 51, No. 19, September 20, 2024
A. The Program covers the following inpatient special psychiatric hospital services:
(1) Medically necessary services for the
number of days, per admission, including days certified by the Department or
its designee;
(2) Medically
necessary mental health services authorized in accordance with COMAR
10.09.59.08 and as set forth in
Regulation .05B(4) of this chapter;
(3) Medically necessary services when these
services are:
(a) Necessary for the provision
of diagnostic, curative, palliative, or rehabilitative treatment; and
(b) Described in the participant's medical
record in sufficient detail to support the invoices submitted for
services.
(4)
Administrative days for the length of time certified by the Department or its
designee;
(5) Leaves of absence for
therapeutic reasons or extenuating circumstances up to 12 hours per day, if the
participant returns the same day, before the census check; and
(6) Observation services. B. The Program
covers partial hospitalization when the hospital has:
(1) Written approval from the Office of
Licensing and Certification Programs to be a provider of partial
hospitalization in accordance with COMAR 10.21.02;
(2) A certificate of need from the Maryland
Health Resources Planning Commission, if required, to be a provider of partial
hospitalization; and
(3) Obtained
preauthorization in accordance with COMAR 10.09.59.08.
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