# COMAR 10.09.02.07: COMAR 10.09.02.07. Payment Procedures > Maryland · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_02_07 ## Section - **Citation:** COMAR 10.09.02.07 - **Heading:** COMAR 10.09.02.07. Payment Procedures - **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 10.09.02.07 ## Text ordance with §D of this regulation . F. The Program shall reimburse providers up to the acquisition cost for diagnostic and therapeutic radiopharmaceuticals, contraceptive products and devices, and injectable medications when the provider submits documentation indicating that the acquisition cost of the product, device, or drug is greater than the reimbursement allowed in §E of this regulation . G. The Program reserves the right to negotiate and establish a different fee for a physician or a group of physicians under contract to a hospital to provide services when a portion of the cost of the contract is paid as the hospital's cost, provided this fee does not exceed limitations set forth in §E of this regulation . H. Supplemental payments on Medicare claims are made subject to the following provisions: (1) Deductible insurance will be paid in full; (2) Beginning with August 1, 2010 dates of service, and subject to the limitations of the State budget, coinsurance, shall be paid: (a) In full for the following: (i) Mental health services; (ii) CPT codes that are priced by report; (iii) Claims for anesthesia services; (iv) Claims from a federally qualified health center; and (v) HCPCS codes beginning with A through W; and (b) For all other claims, at the lesser of: (i) 100 percent of the coinsurance amount; or (ii) The balance remaining after the Medicare payment is subtracted from the Medicaid rate; and (3) Services not covered by Medicare are payable according to §E of this regulation . I. Payments on Medicare claims are authorized if the: (1) Provider accepts Medicare assignments; (2) Medicare makes direct payment to the provider; (3) Medicare has determined that services were medically justified; (4) Services are covered by the Program; (5) Initial billing is made directly to Medicare according to Medicare guidelines. J. The provider may not bill the Department or the participant for: (1) Completion of forms and reports; (2) Broken or missed appointments; (3) Professional services rendered by mail; or quired under COMAR 10.09.09 . P. Reimbursement. (1) The Program shall reimburse providers for all laboratory and other diagnostic services performed by a physician, or by authorized personnel under that physician's supervision, for that physician's patients. (2) Reimbursement shall be according to all applicable provisions of COMAR 10.10.06 and fees established according to §D of this regulation . (3) Maximum reimbursement may not exceed the Medicare laboratory fee established by the Maryland Medicare carrier recognized by the Program. (4) The Program shall reimburse providers for mental health services performed by a physician according to the fees established under COMAR 10.21.25 and the requirements of this chapter. Cross References 10.02.01.04B(2)(b) 10.09.01.06D(2) 10.09.08.10C(1)(b) 10.09.21.04A 10.09.21.06B 10.09.22.06A(3) 10.09.38.06C(4)(d) 10.09.39.02 10.09.39.06H(2) 10.09.49.02B(10)(b) 10.09.49.09C 10.09.49.10B(1)(a) 10.09.55.06D(2) 10.09.64.06G(4) 10.09.76.06C(2) 10.09.77.06C(2)(a) 10.09.80.08D(1)(m) 10.09.80.08D(2)(i) 10.09.80.08E(1)(m) 10.09.80.08E(2)(i) 10.09.80.08F(1)(m) 10.09.80.08F(2)(i) 10.09.96.06D 10.09.96.09D(2) 10.11.03.14B(1) ## 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_07. Check the current official text before relying on it. Not legal advice.