# COMAR 10.09.02.06: COMAR 10.09.02.06. Preauthorization Requirements

> Maryland · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_06

## Section

- **Citation:** COMAR 10.09.02.06
- **Heading:** COMAR 10.09.02.06. Preauthorization Requirements
- **Jurisdiction:** Maryland
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Code of Maryland Regulations / Title 10 MARYLAND DEPARTMENT OF HEALTH / Subtitle 09 MEDICAL CARE PROGRAMS / Chapter 02 Physicians' Services / COMAR 10.09.02.06

## Text

A. The following procedures or services require preauthorization:
(1) Cosmetic surgery;
(2) Contact lens evaluation and fitting;
(3) Lipectomy and panniculectomy;
(4) Transplantations of vital organs;
(5) Services rendered to an inpatient before one preoperative day;
(6) Surgical procedures for the treatment of obesity;
(7) Surgical procedures for the purpose of gender reassignment; and
(8) Elective services from a noncontiguous state.
B. Services which have been determined by Medicare to be ineffective, unsafe, or without proven clinical value are generally presumed to be not medically necessary, but will be preauthorized if the provider can satisfactorily document medical necessity in a particular case. These services are found in the Medicare Carriers Manual, Part 3, Claims Process, Chapter II, Coverage Issues Appendix.
C. Physicians dispensing or prescribing eyeglasses shall comply with the requirements of COMAR 10.09.14 .
D. The Department will preauthorize services when the provider submits to the Department adequate documentation demonstrating that the service to be preauthorized is medically necessary.
E. Preauthorization normally required by the Program is waived when the service is covered and approved by Medicare. Non-Medicare claims require preauthorization according to §§A—D of this regulation.
F. Physicians rendering mental health services shall comply with the preauthorization requirements of COMAR 10.09.70.07.

## Nearby sections

- [COMAR 10.09.02.01 COMAR 10.09.02.01. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_01.md)
- [COMAR 10.09.02.02 COMAR 10.09.02.02. License Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_02.md)
- [COMAR 10.09.02.03 COMAR 10.09.02.03. Conditions for Participation](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_03.md)
- [COMAR 10.09.02.04 COMAR 10.09.02.04. Covered Services](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_04.md)
- [COMAR 10.09.02.05 COMAR 10.09.02.05. Limitations](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_05.md)
- [COMAR 10.09.02.06 COMAR 10.09.02.06. Preauthorization Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_06.md)
- [COMAR 10.09.02.07 COMAR 10.09.02.07. Payment Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_07.md)
- [COMAR 10.09.02.08 COMAR 10.09.02.08. Recovery and Reimbursement](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_08.md)
- [COMAR 10.09.02.09 COMAR 10.09.02.09. Cause for Suspension or Removal and Imposition of Sanctions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_09.md)
- [COMAR 10.09.02.10 COMAR 10.09.02.10. Appeal Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_10.md)
- [COMAR 10.09.02.11 COMAR 10.09.02.11. Interpretive Regulation](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_11.md)

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_06. Check the current official text before relying on it. Not legal advice.