The Program does not cover the following:

1. A. Services for which the IDTF provider cannot supply a properly completed order identifying the authorized ordering practitioner by National Provider Identifier (NPI);

2. B. IDTF services ordered by an:

   1. (1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and
   2. (2) Entity, facility, or another provider that is not an individual.
3. C. Services not adequately documented in the recipient’s medical record;
4. D. Services not medically necessary;
5. E. Procedures that are the provider as investigational or experimental in nature;
6. F. Services which are specifically included as an integral part of another service;
7. G. Consultations;
8. H. Office Visits;
9. I. Injections;
10. J. Surgeries; and
11. K. Therapeutic services.

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

Effective date: April 28, 2014 (41:8 Md. R. 472)

Regulation .04A amended effective January 1, 2018 (44:26 Md. R. 1214)

Regulation .05A amended effective January 1, 2018 (44:26 Md. R. 1214)

Regulation .07B amended effective January 1, 2018 (44:26 Md. R. 1214)

Regulation .07C, I amended effective July 4, 2016 (43:13 Md. R. 712)

Regulation .07D amended effective February 27, 2017 (44:4 Md. R. 252)