# COMAR 10.09.93.09: COMAR 10.09.93.09. Payment Procedures

> Maryland · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_09

## Section

- **Citation:** COMAR 10.09.93.09
- **Heading:** COMAR 10.09.93.09. 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 93 Chronic Hospitals / COMAR 10.09.93.09

## Text

A. Reimbursement of Maryland Chronic Hospitals.
(1) In-State chronic hospitals shall be reimbursed according to:
(a) Rates approved by the HSCRC pursuant to COMAR 10.37.03 ; or
(b) The administrative day rate as follows:
(i) For a participant who is not ventilator-dependent, payment for approved administrative days shall be the estimated Statewide average Medicaid nursing facility payment rate as determined by the Department; and
(ii) For a participant who is ventilator-dependent, payment for approved administrative days shall be the estimated average Medicaid nursing facility payment rate for ventilator-dependent residents as determined by the Department.
(2) State-operated chronic hospitals shall be reimbursed according to Regulation .10 of this chapter . The Department shall make no direct reimbursement to any State-operated chronic hospital.
B. Reimbursement of Out-of-State Hospitals.
(1) The Department shall reimburse an out-of-State hospital that provides a level of service equivalent to that provided at a chronic hospital only if:
(a) The proposed admission is first reviewed by the Department or its designee and the out-of-State placement is determined medically necessary according to Regulation .07A of this chapter ;
(b) The hospital possesses the same certifications and accreditations as the Program requires for a comparable level of services and specific program in a Maryland chronic hospital; and
(c) The hospital meets one of the following conditions:
(i) The hospital proposes to provide a service or specific treatment that the participant cannot obtain in a Maryland chronic hospital; or
(ii) The hospital is located geographically closer to the established residence of the participant than a Maryland chronic hospital.
(2) The Department shall reimburse an out-of-State hospital at the lesser of:
(a) The average rate established by the HSCRC for an equivalent cost center for a Maryland chronic hospital; or
(b) The rate charged by the out-of-State hospital pursuant to 42 CFR Part 412, Subpart O.

## 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)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_10_09_93_09. Check the current official text before relying on it. Not legal advice.