# COMAR 10.09.04.06: COMAR 10.09.04.06. Preauthorization Requirements

> Maryland · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_06

## Section

- **Citation:** COMAR 10.09.04.06
- **Heading:** COMAR 10.09.04.06. 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 04 Home Health Services / COMAR 10.09.04.06

## Text

A. Preauthorization is required for:
(1) More than one visit per type of service per day;
(2) Any service or combination of services specified in Regulation .04 of this chapter and rendered during any 30-day period for which the provider anticipates payments from the program in excess of the Medicaid average nursing facility rate;
(3) Four or more hours of care per day whether the 4-hour limit is reached in one visit or in several visits in one day; and
(4) Any instances in which home health aide services without skilled nursing services are provided.
B. Preauthorization may be:
(1) Issued by telephone when the provider submits to the Department or its designee adequate documentation demonstrating that the service or services are medically necessary.
(2) Denied when the Department, after taking into consideration the particular circumstances of the participant, determines the payments to the provider for any service or combination of services rendered during any 30-day period would exceed the cost to the program of any alternative services which could be used for the same purpose.
Cross References 10.09.04.05F 10.09.04.05H 10.09.04.05I 10.09.04.05J

## Nearby sections

- [COMAR 10.09.04.01 COMAR 10.09.04.01. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_01.md)
- [COMAR 10.09.04.02 COMAR 10.09.04.02. License Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_02.md)
- [COMAR 10.09.04.03 COMAR 10.09.04.03. Conditions for Participation](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_03.md)
- [COMAR 10.09.04.04 COMAR 10.09.04.04. Covered Services](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_04.md)
- [COMAR 10.09.04.05 COMAR 10.09.04.05. Limitations](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_05.md)
- [COMAR 10.09.04.06 COMAR 10.09.04.06. Preauthorization Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_06.md)
- [COMAR 10.09.04.07 COMAR 10.09.04.07. Payment Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_07.md)
- [COMAR 10.09.04.08 COMAR 10.09.04.08. Recovery and Reimbursement](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_08.md)
- [COMAR 10.09.04.09 COMAR 10.09.04.09. Cause for Suspension or Removal and Imposition of Sanctions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_09.md)
- [COMAR 10.09.04.10 COMAR 10.09.04.10. Appeal Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_10.md)
- [COMAR 10.09.04.11 COMAR 10.09.04.11. Interpretive Rule](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_11.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_04_06. Check the current official text before relying on it. Not legal advice.