Find & Ask › Maryland › this rule
COMAR 10.09.20.12 — Conditions for Reimbursement (Community Personal Assistance Services)
MarylandregulationMaryland Department of Health, Medical Care Programs (Medicaid)· effective 2016-03-14
What this rule requires your agency to do
- 1A service is reimbursable only if it is provided by a Medicaid provider who meets the conditions for participation under this chapter.(COMAR 10.09.20.12 — Conditions for Reimbursement (Community Personal Assistance Services))
- 2A service is reimbursable only if it has been preauthorized by the Department in the participant's plan of service.(COMAR 10.09.20.12 — Conditions for Reimbursement (Community Personal Assistance Services))
- 3A service is reimbursable only if it is recommended on the participant's plan of service as necessary to assure the health and safety of the applicant or participant in the community.(COMAR 10.09.20.12 — Conditions for Reimbursement (Community Personal Assistance Services))
- 4A service is reimbursable only if it is provided to an enrolled participant and is medically necessary.(COMAR 10.09.20.12 — Conditions for Reimbursement (Community Personal Assistance Services))
Applies to: personal care
States the conditions a CPAS service must meet to be reimbursed by the Program, including recommendation in the plan of service, Department preauthorization, medical necessity, and delivery by a qualified enrolled provider.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.