# COMAR 10.09.10.07: COMAR 10.09.10.07. Prospective Rates > Maryland · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_07 ## Section - **Citation:** COMAR 10.09.10.07 - **Heading:** COMAR 10.09.10.07. Prospective Rates - **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 10 Nursing Facility Services / COMAR 10.09.10.07 ## Text A. A provider shall be paid the prospective rate for nursing facility services as defined in Regulation .01B of this chapter plus the Nursing Facility Quality Assessment add-on identified in Regulation .11E of this chapter . B. When necessary, each facility’s per diem rate shall be reduced by the same percentage to maintain compliance with the Medicare upper payment limit requirement. C. Power wheelchairs and bariatric beds are not included in the prospective rate, but may be preauthorized for payment in accordance with COMAR 10.09.12 . D. Support Surfaces. (1) Support surfaces are not included in the prospective rate. (2) A provider shall be paid a per diem rate for providing appropriate specialized support surfaces to patients with pressure ulcers or in recovery from myocutaneous flap or graft surgery for a pressure ulcer. (3) A Class A support surface is a mattress replacement which has been approved as a Group 2 Pressure Reducing Support Surface by the Medical Policy of the Medicare Durable Medical Equipment Regional Carrier. A Class A support surface shall be reimbursed per day at the Medicare Durable Medical Equipment Regional Carrier Maryland monthly fee cap, in effect at the beginning of the State fiscal year, for HCPCS Code E0277 multiplied by 12 and then divided by the number of days in the State fiscal year. (4) A Class B support surface is an air fluidized bed which has been approved as a Group 3 Pressure Reducing Support Surface by the Medical Policy of the Medicare Durable Medical Equipment Regional Carrier. A Class B support surface shall be reimbursed per day at the Medicare Durable Medical Equipment Regional Carrier Maryland monthly fee cap, in effect at the beginning of the State fiscal year, for HCPCS Code E0194 multiplied by 12 and then divided by the number of days in the State fiscal year. E. Negative pressure wound therapy is not included in the prospective rate, but is reimbursed in accordance with rates established under COMAR 10.09.12 er day at the Medicare Durable Medical Equipment Regional Carrier Maryland monthly fee cap, in effect at the beginning of the State fiscal year, for HCPCS Code E0194 multiplied by 12 and then divided by the number of days in the State fiscal year. E. Negative pressure wound therapy is not included in the prospective rate, but is reimbursed in accordance with rates established under COMAR 10.09.12 . Reimbursement shall include the cost of pumps, dressings, and containers associated with this procedure. F. Nursing facilities that are owned and operated by the State are not paid in accordance with the provisions of §A of this regulation , but are reimbursed reasonable costs based upon Medicare principles of reasonable costs as described at 42 CFR Part 413. Aggregate payments for these facilities may not exceed Medicare upper payment limits as specified at 42 CFR §447.272. If the Medicare upper payment limit is above aggregate costs for this ownership class, the State may elect to make supplemental payments to increase payments up to the Medicare upper payment limit. G. Final facility rates for the period July 1, 2024 through June 30, 2025 shall be each nursing facility’s quarterly rate, exclusive of the amount identified in Regulation .13A(2) of this chapter , increased by the budget adjustment factor of 2.703 percent, plus the Nursing Facility Quality Assessment add-on identified in Regulation .11E of this chapter and the ventilator care add-on amount identified in Regulation .13A(2) of this chapter when applicable. Cross References 10.09.10.20A(1) 10.09.10.20B ## Nearby sections - [COMAR 10.09.10.01 COMAR 10.09.10.01. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_01.md) - [COMAR 10.09.10.02 COMAR 10.09.10.02. License Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_02.md) - [COMAR 10.09.10.03 COMAR 10.09.10.03. Conditions for Participation](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_03.md) - [COMAR 10.09.10.04 COMAR 10.09.10.04. Covered Services](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_04.md) - [COMAR 10.09.10.05 COMAR 10.09.10.05. Limitations](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_05.md) - [COMAR 10.09.10.06 COMAR 10.09.10.06. Preauthorization Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_06.md) - [COMAR 10.09.10.07 COMAR 10.09.10.07. Prospective Rates](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_07.md) - [COMAR 10.09.10.08 COMAR 10.09.10.08. Interim Working Capital Fund](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_08.md) - [COMAR 10.09.10.09 COMAR 10.09.10.09. Rate Calculation — Administrative and Routine Costs](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_09.md) - [COMAR 10.09.10.10 COMAR 10.09.10.10. Rate Calculation — Other Patient Care Costs](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_10.md) - [COMAR 10.09.10.11 COMAR 10.09.10.11. Rate Calculation — Capital Costs](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_11.md) - [COMAR 10.09.10.12 COMAR 10.09.10.12. Rate Calculation — Nursing Service Costs](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_12.md) - [COMAR 10.09.10.13 COMAR 10.09.10.13. Ventilator Care Nursing Facilities](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_13.md) - [COMAR 10.09.10.14 COMAR 10.09.10.14. Pay-for-Performance — Eligibility](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_14.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_10_07. Check the current official text before relying on it. Not legal advice.