1. A. The Program does not cover the following:

   1. (1) Services not delivered in compliance with Regulation .05 of this chapter;
   2. (2) Services not medically necessary;
   3. (3) Investigational or experimental drugs and procedures;

   4. (4) Services solely for the purpose of:

      1. (a) Prescribing medication;
      2. (b) Administering medication;
      3. (c) Drug or supply pick-up;
      4. (d) Collecting laboratory specimens;
      5. (e) Interpreting laboratory tests or panels; or
      6. (f) Administering injections;
   5. (5) Separate reimbursement to an employee of a program for services that have been provided by and reimbursed directly to a program;
   6. (6) Services provided to or for the primary benefit of individuals other than the participant;
   7. (7) Mobile crisis team services rendered by telehealth with the exception of those specified as permissible via telehealth in Regulation .05 of this chapter;
   8. (8) Behavioral health crisis stabilization center services rendered by telehealth with the exception of those specified in COMAR 10.63.03.21;
   9. (9) Services provided to participants in a hospital inpatient setting; and
   10. (10) Services rendered but not appropriately documented.

2. B. Providers may not be reimbursed by the Program for:

   1. (1) Behavioral health crisis stabilization center services exceeding 23 hours 59 minutes;
   2. (2) Presumptive and definitive drug testing when billed by a behavioral health crisis stabilization center; or
   3. (3) Transportation costs.

Authority: Health-General Article, §§2-104(b), 2-105(b), 15-103, and 15-105, Annotated Code of Maryland

Effective date: May 27, 2024 (51:10 Md. R. 525)

Regulation .07C amended effective July 7, 2025 (52:13 Md. R. 655)

Regulation .07D adopted effective July 7, 2025 (52:13 Md. R. 655)