# COMAR 10.09.93.05: COMAR 10.09.93.05. Covered Services > Maryland · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_05 ## Section - **Citation:** COMAR 10.09.93.05 - **Heading:** COMAR 10.09.93.05. Covered Services - **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 93 Chronic Hospitals / COMAR 10.09.93.05 ## Text A. Chronic hospitals shall provide the following services: (1) Complex respiratory care services; (2) Complex wound care services; (3) Services for participants with multiple co-morbidities, including but not limited to services necessary to care for: (a) Ventilator-assisted individuals who have been ventilator dependent for less than 6 months and who need further medical stabilization or are candidates for weaning from ventilator assistance; (b) Tracheostomy participants who require suctioning more frequently than every 2 hours or are candidates for decannulation; (c) More than two extensive stage IV decubiti which require daily intensive treatment that is not available in a nursing facility; or (d) Extensive post-operative or post-traumatic care with multiple drains or extensive dressing change or therapies beyond the capabilities of a nursing facility; (4) For participants admitted for medically necessary rehabilitation services, physical therapy, occupational therapy, or speech therapy, directed by an interdisciplinary team; and (5) Ancillary services. B. Treatment Plan. (1) Within 24 hours of a participant’s admission, a physician shall perform a documented face-to-face evaluation of the participant and begin developing an individualized treatment plan designed to meet the participant’s assessed needs. (2) By the 7th day of a participant’s admission, an interdisciplinary team shall establish a written, individualized treatment plan for the participant, which shall include, at a minimum: (a) Diagnoses; (b) Treatment goals; (c) Frequency of interventions for each type of service ordered; (d) Duration of treatment of each type of service ordered; and signed to meet the participant’s assessed needs. (2) By the 7th day of a participant’s admission, an interdisciplinary team shall establish a written, individualized treatment plan for the participant, which shall include, at a minimum: (a) Diagnoses; (b) Treatment goals; (c) Frequency of interventions for each type of service ordered; (d) Duration of treatment of each type of service ordered; and (e) Prognosis. (3) The physician-led interdisciplinary team shall update the individualized treatment plan weekly until discharge. C. The Program covers outpatient hospital services provided by a chronic hospital when the services are: (1) Medically necessary; and (2) Provided to individuals who are eligible for Medical Assistance and who are not current inpatients at the chronic hospital, except when payment for certain outpatient services provided to a participant on the date of inpatient admission or within 3 calendar days before the date of an inpatient admission are bundled, in accordance with 42 CFR §412.2(c)(5). D. The program covers the following brain injury community integration program services: (1) Neuro-behavioral management programming, which includes, but is not limited to: (a) Assessment of maladaptive behaviors using valid and reliable behavioral measurement tools; (b) Pharmacologic intervention provided to manage maladaptive behaviors related to brain injury; (c) Neuro-behavioral programming created, implemented, overseen, and revised as needed; (d) Incorporation of neuro-behavioral programming into therapy and care for participants in the community integration program; and (e) Referral to a neuro-psychiatrist, as needed, if a neuro-psychiatrist is not a member of the facility staff; (2) Cognitive skills adaptation and compensation programming, including: (a) Specific programming dedicated to cognitive skills adaptation and compensation; and Incorporation of neuro-behavioral programming into therapy and care for participants in the community integration program; and (e) Referral to a neuro-psychiatrist, as needed, if a neuro-psychiatrist is not a member of the facility staff; (2) Cognitive skills adaptation and compensation programming, including: (a) Specific programming dedicated to cognitive skills adaptation and compensation; and (b) Incorporation of cognitive compensatory strategies into community integration program participant’s interdisciplinary team treatment; (3) Community re-entry programming, including specific programming dedicated to social or pragmatic skills, leisure skills, and life skills; and (4) According to the participant’s needs: (a) The services of a psychiatrist or psychiatric nurse; (b) Services and supports related to substance use disorders and other addictions; (c) Speech therapy, which includes but is not limited to: (i) Cognitive skills; (ii) Communication skills; (iii) Swallowing ability; and (iv) Linguistic programming that assists the patient to connect the meaning of words to their context; (d) Occupational therapy, which includes but is not limited to: (i) Instrumental activities of daily living; and (ii) Community re-entry activities; (e) Physical therapy, which includes but is not limited to: (i) Ambulation; and (ii) Motor planning and coordination; (f) Dietary services, which includes but is not limited to nutritional needs assessment and monitoring; and (g) Case management, which includes but is not limited to: (i) Treatment planning; and (ii) Discharge planning. E. The Program covers administrative days approved by the Department or its designee according to the conditions set forth in Regulation .08C of this chapter . Cross References 10.09.93.04B ## Nearby sections - [COMAR 10.09.93.01 COMAR 10.09.93.01. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_01.md) - [COMAR 10.09.93.02 COMAR 10.09.93.02. License Requirements](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_02.md) - [COMAR 10.09.93.03 COMAR 10.09.93.03. Conditions for Participation — General](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_03.md) - [COMAR 10.09.93.04 COMAR 10.09.93.04. Specific Conditions for Provider Participation — Brain Injury Community Integration Program](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_04.md) - [COMAR 10.09.93.05 COMAR 10.09.93.05. Covered Services](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_05.md) - [COMAR 10.09.93.06 COMAR 10.09.93.06. Limitations](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_06.md) - [COMAR 10.09.93.07 COMAR 10.09.93.07. Medical Eligibility](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_07.md) - [COMAR 10.09.93.08 COMAR 10.09.93.08. Utilization Review](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_08.md) - [COMAR 10.09.93.09 COMAR 10.09.93.09. Payment Procedures](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_09.md) - [COMAR 10.09.93.10 COMAR 10.09.93.10. Cost Reporting — State-Operated Chronic Hospitals](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_10.md) - [COMAR 10.09.93.11 COMAR 10.09.93.11. Cost Settlement — State-operated Chronic Hospitals](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_11.md) - [COMAR 10.09.93.12 COMAR 10.09.93.12. Cost Settlement for State-operated Chronic Hospitals — Payments and Appeals](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_12.md) - [COMAR 10.09.93.13 COMAR 10.09.93.13. Recovery and Reimbursement](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_13.md) - [COMAR 10.09.93.14 COMAR 10.09.93.14. Cause for Suspension or Removal and Imposition of Sanctions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_14.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_05. Check the current official text before relying on it. Not legal advice.