Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.56 - Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder › Section 10.09.56.21 - Limitations

Current through Register Vol. 51, No. 14, July 12, 2024
A. Reimbursemen may
				  be made by the Program only when all of the requirements of this chapter are
				  met.
B. Residential habilitation
				  services may not be reimbursed for the same date of service as intensive
				  individual support services, therapeutic integration services, intensive
				  therapeutic integration services, or respite care.
C. Therapeutic integration services,
				  intensive therapeutic integration services, and intensive individual support
				  services under this chapter and school health-related services under COMAR
				  10.09.50 may not be reimbursed for the same period of the same day.
D. Therapeutic integration and intensive
				  therapeutic integration services may not be rendered during the same week to a
				  participant.
E. Therapeutic
				  integration and intensive therapeutic integration services may include
				  transportation time when at least 2 units of service have been provided
				  on-site, and the maximum units of service billed may not exceed 12
				  units.
F. Environmental
				  accessibility adaptations may be reimbursed only if preauthorized by the State
				  Department of Education.
G. If an
				  environmental accessibility adaptation is anticipated to cost over $500, at
				  least two bids or prices shall be obtained, based on which the State Department
				  of Education may approve the purchase.
H. The Program may reimburse for a
				  participant not more than:
(1) One unit per
				  date of service for residential habilitation services at either the regular or
				  intensive level;
(2) 40 units of
				  therapeutic integration services per week;
(3) 30 units of intensive therapeutic
				  integration services per week;
(4)
				  12 units or fewer than two units of therapeutic integration or intensive
				  therapeutic integration services for a date of service;
(5) 50 units of intensive individual support services
				  per week;
(6) 48 units of respite
				  care for a date of service;
(7)
				  672 units of respite care per State fiscal year;
(8) 12 units of family consultation for a date of
				  service;
(9) 80 units of family
				  consultation per State fiscal year;
(10) A total of $2,000 for environmental accessibility
				  adaptations over a 36-month period;
(11) 16 units of intensive individual support services
				  per day;
(12) 30 units of adult
				  life planning services per State fiscal year, for participants 16 years old or
				  older;
(13) A lifetime maximum of
				  90 units of adult life planning services per participant, for participants 16
				  years old or older; and
(14) 15
				  units of retainer payment per calendar year at either the regular or intensive
				  level when the participant is absent from the residential habilitation program
				  for the purposes of family visitation, hospitalization, or other overnight
				  stays.