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.
Authority: Health-General Article, §§2-104(b), 15-102.8, 15-103, and 15-105, Annotated Code of Maryland
Effective date: April 10, 2017 (44:7 Md. R. 354)
Regulation .05B amended effective September 9, 2019 (46:18 Md. R. 774); May 1, 2023 (50:8 Md. R. 338)
Regulation .07A amended effective December 31, 2018 (45:26 Md. R. 1245)