RSM 5, Section 200: Vendor Fees
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Updated: 6/25/2025
201 Medical Services
201.01 Exams & Office Visits
| CPT Code | Description | Fee |
|---|
| 99204 |
Specialist Examination | $209 per exam & report |
| 99203 |
Health Status (GME); Medical Office Visit; new patient | $140 per exam & report |
| 99213 |
Health Status (GME); Medical Office Visit; established patient | $114 per exam & report |
| 90791 |
Psychiatric Evaluation (60-90 minutes)
Integrated biopsychosocial assessment, including history, mental status, and recommendations. The evaluation may include communication with family or other sources and review and ordering of diagnostic studies. | $212 per evaluation & report |
| 99214 |
Attending Physician (DDS only) | $160 per evaluation & report |
201.02 Additional Fees
| CPT Code | Description | Fee |
|---|
| 90785 |
Interactive Complexity
May be included when an interpreter, language translator, guardian or other third parties such as welfare agencies, parole and probation officers, or school officials are needed during the appointment. | $18 flat rate |
|
n.a. |
Missed Appointment/Cancellation Fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling.
- Applies to all services in Section 200.
| Not to exceed 25% of the authorized service fee.
|
202 Psychotherapy
| CPT Code | Description | Fee |
|---|
| 90832 |
Psychotherapy, physician, clinical psychologist, licensed clinical social worker or licensed clinical professional counselor (30 minutes) | $96 maximum for 30-minute session |
| 90834 |
Psychotherapy, physician, clinical psychologist, licensed clinical social worker or licensed clinical professional counselor (45 minutes) | $127 maximum for 45-minute session |
| 90837 |
Psychotherapy, physician, clinical psychologist, licensed clinical social worker or licensed clinical professional counselor (60 minutes) | $186 maximum for 60-minute session |
203 Psychological Testing –
OFS or OBVS only
203.01 Comprehensive Assessment –
OFS or OBVS only
| CPT Code | Description | Fee |
|---|
| 96130, 96131 & 99202 |
Comprehensive Adult Psychological Assessment – individuals 18 and older.
Includes:
- 96130: $148 (flat rate) for the first hour of psychological IQ test, MSE and ADLS.
- 96131: $210 ($105 per hour up to 2 hours) for psychological test administration and scoring.
- 96131: $105 per hour for academic achievement testing.
- 99202: $91 (flat rate) for adult clinical interview.
Expectations:
Formalized psychological assessment, including IQ test (WAIS), academic achievement (WRAT), activities of daily living, mental status exam, and clinical review. Requires completion of
Referral for Psychological Services (RS-4d). | $554
|
| 96130, 96131 & 99203 |
Comprehensive Child Psychological Assessment – individuals 17 and younger.
Includes:
- 96130: $148 (flat rate) for the first hour of psychological IQ test, MSE and ADLS.
- 96131: $210 ($105 per hour up to 2 hours) for psychological test administration and scoring.
- 96131: $105 per hour for academic achievement testing.
- 99203: $140 (flat rate) for child psych clinical interview with child & parent/guardian.
Expectations:
Formalized psychological assessment, including IQ test (WAIS), academic achievement (WRAT), activities of daily living, mental status exam, and clinical review. Requires completion of
Referral for Psychological Services (RS-4d) (LARGE print). | $603
|
203.02 Supplementary Tests (Psychologist) –
OFS or OBVS only
| CPT Code | Description | Fee |
|---|
| 96131 |
Learning Disability Evaluation Supplement
(Note: not to be combined with Memory Disorder Evaluation)
-
During authorization: May be included on the authorization when the individual reports a learning disability.
-
During assessment: The Woodcock Johnson Extended Battery may be administered after the WAIS and WRAT have been completed and the results indicate a learning disability (i.e., the IQ is above 70 and WRAT score is below 70 or the IQ score is above 70 and the WRAT score is significantly lower) to provide information regarding the extent of an individual's learning disability and vocational implications. If learning disability is not indicate, then the Woodcock Johnson Extended Battery may not be administered, and the LD Supplement may not be billed.
| $105 per hour, up to $210 (2 hours) |
| 96131 |
Memory Disorder Evaluation
(Note: not to be combined with Learning Disorder Evaluation)
Use when the Wechsler Memory Scale IV is required to evaluate the extent of forgetfulness, distractibility, altered memory state, or memory loss when:
- Consumer reports having experienced certain conditions (e.g. head trauma, asphyxiation, stroke, exposure to toxins/chemicals, dementia, chronic heavy drug and/or alcohol dependence, Parkinson’s, Lyme’s, and/or chronic seizures), and
- Credible sources familiar with the person’s daily functioning are not available to provide information to document memory problems comprehensively and accurately.
| $105 per hour, up to $210 (2 hours) |
| 96131 |
Personality Disorder Evaluation
May be included on authorization when existing documentation suggests that personality disorder may be present and may be used with other supplements. | $105 per hour, up to $210 (2 hours) |
| 96131 |
Other Supplementary Testing
Note: For individuals in the VR or IL programs, other supplementary testing in excess of one additional hour requires administrative approval. | $105 per hour |
| 96130, 96131 & 99202 |
Neuropsychological Testing
Note: maximum of 6 hours.
Requires completion of
Referral for Neuropsychological Evaluation (RS-4i) and approval of the supervisor. Not to be combined with a Comprehensive Psychological Evaluation.
Includes:
- 96130: $148 (flat rate) for the first hour of neuropsychological testing.
- 96131: $577 ($105 per hour up to 5.5 hours) for neuropsychological test administration and scoring.
- 99202: $91 (flat rate) for adult clinical interview
| $816 (7-hour maximum unless exception granted) |
203.03 Additional Fees –
OFS or OBVS only
| CPT Code | Description | Fee
|
|---|
| Sign Language |
Sign language interpretation by the psychologist when testing consumers who are deaf, hard of hearing or deaf/blind who require this mode of communication. | $160 per evaluation |
| 90785 |
Interactive Complexity
May be included when an interpreter, language translator, guardian or other third parties such as welfare agencies, parole and probation officers, or school officials are needed during the appointment. | $18 flat rate |
|
n.a. |
Missed Appointment/Cancellation Fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling.
- Applies to all services listed in Section 203
| Not to exceed 25% of the authorized service fee.
|
|
n.a. |
Travel Fee
Travel fee applies only for psychologists conducting specialty evaluations not available in the region; applies to travel over 50 miles round trip, and with approval of the OFS or OBVS Director, or DDS MRO Office; scheduling of more than on consumer the same day is strongly encouraged. | $35 per hour |
204 Psychological Testing –
DDS only
204.01 Evaluation & Assessment –
DDS only
| CPT Code | Description | Fee |
|---|
| 90791 & 90899 |
Adult Mental Status Evaluation
- 90791: $212 Comprehensive Mental Status Evaluation
- 90899: $27 Mini Mental State Examination
| $239
|
| 90791 & 90899 |
Child Mental Status Evaluation
- 90791: $212 Comprehensive Mental Status Evaluation
- 90899 (child): $54 Mini Mental State Examination
| $266
|
96130, 96131 & 90899
|
Adult Cognitive Assessment
Clinical interview, MSE, ADLs and psych test administration and scoring. Refer to Structure for incorporation of 96131 & 90899 CPT coding.
- 96130: $148 Psych testing first hour
- 96131: $105 x 1.5 Psych testing additional hour
- 90899: $140
| $446
|
| 96130, 96131 & 90899 |
Child Cognitive Assessment
Clinical interview, MSE, ADLs and psych test administration and scoring. Refer to Structure for incorporation of 96131 & 90899 CPT coding.
- 96130: $148 Psych testing first hour
- 96131: $105 x 2 Psych testing additional hour
- 90899: $209
| $515
|
204.02 Supplementary Tests (Psychologist) –
DDS only
| CPT Code | Description | Fee |
|---|
96131
|
Memory Testing
Refer to Structure for incorporation of 96131 CPT coding. (96131 x 2 hours)
| $210
|
96131
|
Supplemental Testing
Refer to Structure for incorporation of 96131 CPT coding. | $105
|
204.03 Additional Fees –
DDS only
| CPT Code | Description | Fee |
|---|
| T1013-ADTM |
Interactive Complexity
May be included when an interpreter, language translator, guardian or other third parties such as welfare agencies, parole and probation officers, or school officials are needed during the appointment. Refer to Structure for incorporation of 90785 Interactive Complexity coding. | $17 flat rate |
|
n.a. |
Missed Appointment/Cancellation Fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling.
- Applies to all services listed in Section 204.
| Not to exceed 25% of the fee.
|
|
n.a. |
Travel Fee
Travel fee applies only for psychologists conducting specialty evaluations not available in the region; applies to travel over 50 miles round trip, and with approval of the OFS or OBVS Director, or DDS MRO Office; scheduling of more than on consumer the same day is strongly encouraged. | $35 per hour |
205 Physical Medicine and Allied Medical Services
205.01 Audiology
| CPT Code | Description | Fee |
|---|
| 92557 |
Audiological Examination | $45 flat rate |
| 92570 |
Additional Audiological Testing – acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing and acoustic reflex decay testing | $40 flat rate |
| 92626 |
Communication Evaluation by Audiologist (aural rehabilitation and/or auditory processing) – first hour | $106 first hour |
| 92627 |
Communication Evaluation by Audiologist (aural rehabilitation and/or auditory processing) – additional 15 minutes; maximum 1¼ hours | $25 per 15 minutes; 1¼ hour max in additional 15-minute segments (total service maximum is 2¼ hours) |
| 92626 |
Hearing Aid Evaluation – to determine the most appropriate aid/aids for the consumer | $106 first hour |
| 92627 |
Hearing Aid Evaluation – to determine the most appropriate aid/aids for the consumer – additional 15 minutes; maximum 1 hour | $25 per 15 minutes; 1¼ hour max in additional 15-minute segments (total service maximum is 2 hours) |
| 92626 |
Hearing Aid Testing & Check – to determine if current or new aids are working | $106 first hour |
| 92627 |
Hearing Aid Evaluation Testing & Check – to determine if current or new aids are working – additional 15 minutes; maximum 1 hour | $25 per 15 minutes; 1¼ hour max in additional 15-minute segments (total service maximum is 2 hours) |
| 92626 |
Hearing Aid Fitting – to program and adjust new aids | $106 first hour |
| 92627 |
Hearing Aid Fitting – to program and adjust new aids – additional 15 minutes; maximum 1 hour | $25 per 15 minutes; 1¼ hour max in additional 15-minute segments (total service maximum is 2 hours) |
|
Hearing Aids | Based on the report and recommendation of a DORS-approved licensed audiologist
|
Unit Cost to Vendor: |
Mark-up: |
|---|
$400 and less per aid
| $300 for first aid;
$200 for second | $401-$800 per aid
| $400 for first aid;
$300 for second | $801 and up per aid
| $500 for first aid;
$400 for second |
Unit Cost to Vendor – includes required accessories and options. |
Mark-up – includes ear mold impressions and ear molds constructed of the recommended materials, including hypo-allergenic materials; fitting hearing aid orientation and instructions; adjustments and programming; follow-up visits during initial 30- to 90-day trial period. |
205.02 Vision Services
| CPT Code | Description | Fee |
|---|
| 99205 |
Low Vision Exam | $275 flat rate
|
| 92083 |
Visual Field Test | $80 flat rate |
| 99202 |
Device Fitting up to 30 minutes | $91
|
| 99214 |
Facility Fee (Wilmer at the Baltimore location only) | $160
|
| 92002 |
Exam for Eyeglasses | $106 flat rate |
|
n.a. |
Eyeglasses & Contacts
Use the
fee exception process to request consideration of payment in excess of these fees. |
- Frames – up to $100
- Lenses – as charged by the provider
- Contact Lenses (medically necessary only) – $150
|
205.03 Occupational & Physical Therapy
| CPT Code | Description | Fee |
|---|
| 97750 |
Occupational Therapy Evaluation | $42 per 15 minutes;
4 hour maximum |
| 97750 |
Physical Therapy Evaluation | $42 per 15 minutes;
4 hour maximum |
| 97750 |
Functional Capacity Evaluation by an occupational or physical therapist, with written report | $42 per 15 minutes;
4 hour maximum |
| 97530 | Physical Therapy/Occupational Therapy Treatment | $46 per 15 minutes |
205.04 Speech & Language
| CPT Code | Description | Fee |
|---|
| 92523 |
Speech & Language Evaluation | $282 flat rate |
| 92507 |
Speech & Language Treatment | $94 flat rate per session |
| 92607 |
Augmentative Communication Evaluation | $154 first hour |
| 92608 |
Augmentative Communication Evaluation | $60 each additional 30 minutes |
| 92609 |
Augmentative Communication Treatment | $128 per session |
205.05 Additional Fees
| CPT Code | Description | Fee |
|---|
| 90785 |
Interactive Complexity
May be included when an interpreter, language translator, guardian or other third parties such as welfare agencies, parole and probation officers, or school officials are needed during the appointment. | $18 flat rate |
|
n.a. |
Missed Appointment/Cancellation Fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling. | Not to exceed 25% of the authorized service fee. |
206 Vocational and Allied Services
Note: Missed Appointment/No Show Fee applies to services in this section (Section 206) only if indicated.
206.01 Academic Services
| Description | Fee |
|---|
|
College/University Training | Customary charge for Maryland public institution; for out-of-state or private, up to maximum in-state rate per credit hour or semester established for attendance at the University of Maryland, College Park, unless exception granted. Consistent with policy in
RSM 2, Section 1500. |
Proprietary & Private Career Schools – Vocational Skills Training
Certified by Maryland Higher Education Commission or a similar commission in another state, U.S. Department of Veterans Affairs, or industry-based certification (e.g., Microsoft), unless exception approved by Office Director) | Not to exceed usual and customary charge if total cost is up to $2,500; over $2,500, fee to be determined by designated DORS HQ staff based on current Montgomery College fees and availability; see
RSM 2, Section 1512. |
|
GED Examination | $45 – Full Battery |
|
GED Re-Testing | $11.25 – Single Modules |
Academic Tutoring Services
Missed appointment fee applies. | $30 per hour |
206.02 Interpreting & Translation
| Description | Fee |
|---|
|
Translators – Foreign Language | Per state contract (see RSM 5, Attachment 100-2) or as negotiated |
|
Interpreters – ASL | See
ASL Interpreter Reference Guide
|
|
Interpreters – Deaf-Blind | Determined based on individual needs; requires approval of OBVS Director. |
|
Braille Transcription | $25 per hour for straight text; $35 per hour for:
- Math/science
- Anything requiring Nemeth Code
- Graphs & charts
- Braille music
|
206.03 Medical Records
| Description | Fee |
|---|
|
Medical Records – Photocopies of pertinent history, physical exams and progress notes | $15 for retrieval, preparation and mailing |
|
Medical Records – Written/dictated abstract from a treating physician that includes a report of a physical examination within the last six months (DDS Only) | $35 |
|
Medical Records – Written/dictated abstract from a licensed health care provider (DDS Only) | $26 |
206.04 Blindness & Vision Services
| Description | Fee |
|---|
Orientation and Mobility (O&M) Training by a certified instructor. Instructor must have a COMS or NOMC certification.
Missed appointment fee applies. | $90 per hour |
O&M or Rehabilitation Teaching by a CRVT with full communication for deaf/blind consumers
Missed appointment fee applies. | $135 per hour for provider who has been pre-approved by OFS or OBVS Director |
Rehabilitation Teaching without certification
Missed appointment fee applies. | $60 per hour
|
Rehabilitation Teaching with CVRT, CLVT, NCRTB or Certified TVI
Missed appointment fee applies. | $90 per hour |
VR Support Services for the Deaf-Blind – provided by SSPs of DORS-approved provider. Charge for provider travel applies.
Missed appointment fee applies. | $30 per hour |
Reader Services
Missed appointment fee applies. | Double minimum wage
|
Hotel costs for one night
DORS will provide a one night hotel fee of up to $125. Vendor will invoice for hotel fees with a copy of the hotel folio. (Requires Administrative Approval.)
| $125 flat rate
- For hourly vendors (O&M, Teachers for the blind, AT providers) who are traveling more than 70 miles one way from their home/business to the consumer’s home/worksite.
AND
- The Vendor is providing services for more than three consumers, or more than 12 total hours of assessment/training.
|
206.05 Benefits Planning
| Description | Fee |
|---|
|
Benefits Planning Services
Refer to the
Benefits Planning Desk Reference (RS-1n) for a detailed description regarding these services, including when they can be provided. | - General Benefits Consultation: $350
- Phase 1 Pre-Employment Benefits Planning: $1,120
- Phase 2 Job Placement & Employment/ Maintenance Services: $280
- Phase 3 Developing Supports for DORS Case Closure: $140
- Benefits Check-in for Returning DORS Consumer: $140
- Special Circumstances: $70/hour
- Provider Travel: $35/hour
|
206.06 Other Services
| Description | Fee |
|---|
|
Acquired Brain Injury (ABI) Onsite Team Consult | $24 per 15-minute unit with a 2-hour maximum per consumer |
Personal Assistance Services
Missed appointment fee applies. | Double minimum wage |
|
Personal Assistance Services – Travel to consumer home or employer | $35 per hour |
Travel Training
Missed appointment fee applies. | $35 per hour |
206.07 Additional Fees
| Description | Fee |
|---|
Missed Appointment/Cancellation Fee – applies to services in this section only if indicated.
| Not to exceed 25% of the authorized service (up to 3 hours of service), but not less than $35. DORS will pay fee only if less than 24 hours notice was provided and another consumer was not scheduled in place of the individual canceling.
Vendor will be paid for travel time if there was no notification of cancellation prior to their departure. |
|
|
Transportation Services – Private or Public Vehicle | Not to exceed State rate: see
RSM 2, Section 717.04 |
207 Rehabilitation Technology Services
207.01 Assistive Technology (AT) Services
| Description | Fee |
|---|
Assistive Technology (AT) Services (provided by an approved individual or facility): Training, Equipment, setup, etc.
Missed appointment fee applies. | $90 per hour |
Assistive Technology Evaluation – provided by approved individual or facility.
Missed appointment fee applies. | $120 per hour for maximum of 3 hours |
207.02 Driver Assessment & Driver Training
| Description | Fee |
|---|
|
Assessment - Clinical Pre-Driving-Adapted Vehicle | $168 per hour up to 2 hours.
Note: Also requires
Behind-the-Wheel Adapted Driving Assessment - Car or Van. |
|
Behind-the-Wheel Adapted Driving Assessment - Car | $180 per hour up to 4 hours.
Note: Also requires
Assessment - Clinical Pre-Driving-Adapted Vehicle. |
Behind-the-Wheel Adapted Driving Assessment - Van Mid-Tech
| $200 per hour up to 4 hours.
Note: Also requires Assessment - Clinical Pre-Driving-Adapted Vehicle. (This item will also be used for Passenger-Only assessments) |
|
Behind-the-Wheel Adapted Driving Assessment- High-Tech Vehicle | $225 per hour up to 4 hours.
Note: Also requires
Assessment - Clinical Pre-Driving - Adapted Vehicle. |
|
Driver Training - Adapted Car | $180 per hour. Estimated number of hours may be found in driver assessment report. |
|
Driver Training - Adapted Van (Mid-Tech) | $200 per hour. Estimated number of hours may be found in driver assessment report. |
|
Driver Training - Adapted Van (High-Tech) | $225 per hour. Estimated number of hours may be found in driver assessment report. |
|
VEAPA - Vehicle Consultation | $150 per hour. Number of hours to be determined by DRS and documented in adapted driving equipment training report. |
|
VEAPA - Estimate | $150 flat fee. |
|
Non-Adapted Driving: Behind-the-Wheel Assessment | $180 per hour up to 2 hours.
Note: Also requires
Non-Adapted Vehicle: Clinical Pre-Driving Assessment. (This item will also be used for Low Vision Driving assessments.) |
|
Non-Adapted Vehicle: Clinical Pre-Driving Assessment | $168 up to 2 hours.
Note: Also requires
Non-Adapted Driving: Behind-the-Wheel Assessment. (This item will also be used for Low Vision Driving assessments.) |
|
Driver Training - BTW - Non-Adapted Vehicle | $180 per hour. Estimated number of hours may be found in the driver assessment report. (This item will also be used for Low Vision Driving assessments.) |
|
Vendor Travel for Driver Assessment, Driver Training, and Potential Modifications | Contact RTS.
|
207.03 Vehicle Modifications
| Description | Fee |
|---|
|
Pre-Bid Conference Consultation | $150 flat fee |
|
Vehicle Modification Step 2: Fittings (Mid-Final) | $150 per hour. Number of hours to be determined by DRS. |
|
Post-Modification Training - Adapted Car | $180 per hour. Number of hours to be determined by DRS and documented in adapted driving equipment training report. |
|
Post-Modification Training - Adapted Mid-Tech Vehicle | $200 per hour. Number of hours to be determined by DRS and documented in adapted driving equipment training report. |
|
Post-Modification Training - High-Tech Vehicle | $225 per hour. Number of hours to be determined by DRS and documented in adapted driving equipment training report. |
|
Vendor Travel for Modification and Post-Modification Services | Contact RTS.
|
208 Deaf Employment Services
208.01 Rehabilitation Communication Services (RCS)
| Description | Fee |
|---|
|
RCS Intake & Planning | $140 flat rate |
|
RCS Job Development Preparation | $70 per hour |
|
RCS Job Development | $70 per hour, to be issued in 20-hour increments. If more than 60 hours are required, a team meeting and regional administrative approval is required. |
|
RCS On-site Follow Up | $70 per hour. Regional administrative approval required to authorize hours in excess of the
Job Coaching Fading Schedule before transition to natural supports. |
|
RCS Job Retention Evaluation | $70 per hour |
|
RCS Job Retention On-site Follow Up | $70 per hour |
|
RCS On-site Communication Support during WBLE | $70 per hour. Regional administrative approval required to authorize hours in excess of the
Job Coaching Fading Schedule before transition to natural supports. |
|
RCS Missed Appointment/Cancellation Fee | $35 flat fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling. |
|
RCS Vendor Travel for Communication Services | $35 per hour |
208.02 Vocational Interpreter Services (VIS)
Note: A
Vocational Interpretation Services Log (RS-7u), signed by the consumer, is required with each invoice.
| Description | Fee |
|---|
|
VI - Job Development Preparation | $65 per hour, maximum 8 hours. |
|
VI - On-site Interview Assistance | $65 per hour. |
|
VI - On-site Vocational Interpretation | $65 per hour. Regional administrative approval required to exceed 20 hours per employment placement. |
|
VI - On-site Vocational Interpretation during WBLE | $65 per hour. Authorized hours may not exceed the
Job Coaching Fading Schedule for short-term job coaching without prior administrative approval. |
|
VI - Missed Appointment/Cancellation Fee | $35 flat fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling.
|
|
VI - Vendor Travel for Communication Services | $35 per hour |
209 Blind Employment Services
| Description | Fee |
|---|
|
IES Intake & Planning | $88 an hour up to 2 hours.
|
|
IES Job Development Preparation (including resume and cover letter) | $88 per hour up to 6 hours for resume development, interview prep and cover letter creation.
|
|
IES Job Development | $88 per hour, to be issued in 20-hour increments. If more than 60 hours are required, a team meeting and regional administrative approval is required. |
|
IES On-site Follow Up | $88 per hour. Regional administrative approval required to authorize hours in excess of the Job Coaching Fading Schedule before transition to natural supports. |
|
IES Job Retention Evaluation | $88 per hour |
|
IES Job Retention On-site Follow Up | $88 per hour |
|
IES Support during WBLE | $88 per hour |
|
IES Missed Appointment/Cancellation Fee | $35 flat fee
DORS will pay missed appointment/cancellation fee only if less than 24 hours' notice was provided and another consumer was not scheduled in place of the individual canceling.
|
|
IES Vendor Travel for Communication Services | $35 per hour |
210 Dental Services
Note: DORS does not provide funding for preventive dental services.
See
RSM 5, Section 600, Maryland Medicaid Healthy Smiles Dental Fee Schedule.
