Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 21 - MENTAL HYGIENE REGULATIONS
Chapter 10.21.30 - Telemental Health Services
Section 10.21.30.10 - Reimbursement

Universal Citation: MD Code Reg 10.21.30.10

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

A. There are three categories of fees that the Department shall reimburse an approved TMH provider, as applicable:

(1) Originating site fee;

(2) Professional fee; and

(3) Telepresenter fee.

B. Originating Site Fee.

(1) The originating site facility fee is set forth by the Center for Medicare and Medicaid Services, published annually and included in the Medicare Physician Fee Schedule Final Rule, issued by November 1, prior to the start of the calendar year for which it is effective.

(2) Originating sites only may file for reimbursement and shall use the appropriate code modifier.

(3) Fees paid to the originating site may be used to:
(a) Purchase, install, and maintain video conferencing equipment;

(b) Pay for line or per minute usage charges, or both; and

(c) Any additional programmatic, administrative, clinical or contingency support at the originating site.

C. Professional Fee. Professional Fee for individual providers or OMHC providing TMH is set forth in COMAR 10.21.25.

D. Telepresenter Fee. Telepresenter Fees for assisting in TMH are set forth in 10.21.25 and subject to the following requirements prior to billing:

(1) A telepresenter fee is applicable only when, due to medical necessity, a licensed independent practitioner is required to present the individual to the distant provider to successfully complete the examination;

(2) Fees for telepresenters that are not licensed independent practitioners, and fees for telepresenters that are licensed independent practitioners, but their presence is not medically necessary, are included as part of the originating site facility fee; and

(3) The distant provider shall clearly document in the individual's medical record the rationale requiring the involvement of the licensed independent practitioner, as medically necessary, at any particular session.

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.
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