Appeal Procedure Appeals related to Medical Assistance are conducted under the authorization of COMAR 10.09.36.09 and in accordance with COMAR 10.01.03 and 28.02.01. To initiate an appeal, the appeal must be filed within 30 days of receipt of a notice of administrative decisions in accordance with COMAR 10.01.03.06. Procedure Codes and Fee Schedules January 2017 EPSDT Acupuncture Services Description Procedure Requires Maximum Maximum Code Pre-Auth Number of Payment Units 97810 N 1 $28.37 Acupuncture, 1 or more needles; without electrical stimulation, initial 15-minutes of personal one-on-one contact with the patient 97811 Acupuncture without N 1 $21.11 electrical stimulation, each additional 15-minutes of personal one-on-one contact with the patient, with of needle(s) 97813 Acupuncture with electrical N 1 $30.27 stimulation, initial minutes of personal one-on- one contact with the patient 97814 Acupuncture with electrical N 1 $23.86 stimulation, initial minutes of personal one-on- one contact with the patient, with re-insertion of needle(s) EPSDT Chiropractic Services Procedure Description Requires Maximum Maximum Code Pre-Auth Number of Payment Units
Appeal Procedure Appeals related to Medical Assistance are conducted under the authorization of COMAR 10.09.36.09 and in accordance with COMAR 10.01.03 and 28.02.01. To initiate an appeal, the appeal must be filed within 30 days of receipt of a notice of administrative decisions in accordance with COMAR 10.01.03.06. Procedure Codes and Fee Schedules January 2017 EPSDT Acupuncture Services Procedure Code Description Requires Pre-Auth Maximum Number of Units Maximum Payment 97810 Acupuncture, 1 or more needles; without electrical stimulation, initial 15-minutes of personal one-on-one contact with the patient N 1 $28.37 97811 Acupuncture without electrical stimulation, each additional 15-minutes of personal one-on-one contact with the patient, with of needle(s) N 1 $21.11 97813 Acupuncture with electrical stimulation, initial of personal one-on- one contact with the patient N 1 $30.27 97814 Acupuncture with electrical stimulation, initial of personal one-on- one contact with the patient, with re-insertion of needle(s) N 1 $23.86 EPSDT Chiropractic Services Procedure Code Description Requires Pre-Auth Maximum Number of Units Maximum Payment minutes minutes
EPSD-NEW-MANUAL-FINAL-01-12-17.docx