The Program does not cover the following under these regulations:

1. A. Services not encompassed by the physician assistant’s written delegation agreement with the physician, if required by the state in which services are provided;
2. B. Services not medically necessary;
3. C. Services prohibited by the Board;
4. D. Services prohibited in the state in which services are provided;
5. E. Physician assistant services included as part of the cost of an inpatient facility, hospital outpatient department, or freestanding clinic;

6. F. Visits by or to the physician assistant solely for the purpose of the following:

   1. (1) Prescription, drug, or food supplement pickup;
   2. (2) Recording of an electrocardiogram;
   3. (3) Ascertaining the patient's weight;
   4. (4) Interpretation of laboratory tests or panels; or
   5. (5) Prescribing or administering oral medications;
7. G. Drugs and supplies which are acquired by the licensed and certified physician assistant at no cost;
8. H. Injections and visits solely for the administration of injections, unless medical necessity and the patient's inability to take appropriate oral medications are documented in the patient's medical record;
9. I. More than one visit per day per participant unless adequately documented as an emergency situation;
10. J. Services paid under the free-standing dialysis program described in COMAR 10.09.22;
11. K. Physician assistant billings for those laboratory or X-ray services performed by another facility, which shall bill the Program directly;
12. L. Immunizations required for travel outside the continental United States;
13. M. Acupuncture;
14. N. Hypnosis;
15. O. Travel expenses;
16. P. Prescriptions and injections for central nervous system stimulants and anoretic agents when used for weight control;
17. Q. Investigational or experimental drugs and procedures;
18. R. Services denied by Medicare as not medically justified; and
19. S. Services for which the patient specifically requests to see a physician.

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

Effective date: May 11, 2015 (42:9 Md. R. 647)

Regulation .03A amended effective July 10, 2023 (50:13 Md. R. 512)

Regulation .06 amended effective September 26, 2016 (43:19 Md. R. 1072)

Regulation .06G amended effective July 10, 2023 (50:13 Md. R. 512)