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OBR 8.02

(d) Intentionally Pitch at the Batter.
If, in the umpire’s judgment, such a violation occurs, the umpire may elect either to:
1. Expel the pitcher, or the manager and the pitcher, from the game, or
2. may warn the pitcher and the manager of both teams that another such pitch will result in the immediate expulsion of that pitcher (or a replacement) and the manager.
If, in the umpire’s judgment, circumstances warrant, both teams may be officially “warned” prior to the game or at any time during the game.
(League Presidents may take additional action under authority provided in Rule 9.05)
Rule 8.02(d) Comment: To pitch at a batter’s head is unsportsmanlike and highly dangerous. It should be—and is—condemned by everybody. Umpires should act without hesitation in enforcement of this rule.

From the MLBUM

7.4 INTENTIONALLY PITCHING AT THE BATTER
Official Baseball Rule 8.02(d) provides that the pitcher shall not intentionally pitch at the batter.
If, in the umpire's judgment, such a violation occurs, the umpire may either (1) issue a warning;
(2) eject the pitcher immediately; or (3) eject the pitcher and his manager immediately. After a warning has been issued, subsequent violations result in ejection of the pitcher and manager. If the first violation in a game results in a pitcher being immediately ejected, the umpire shall
issue a warning to both managers that subsequent violations in that game will result in ejection of the pitcher and manager.

Warnings should be indicated forcefully and assertively so there is no doubt in anyone's mind that a warning has been issued. The umpire should step out from behind the plate and assertively point at the pitcher while announcing the warning. The umpire should then do likewise and point
toward each dugout while announcing the warning.

As Rule 8.02(d) implies, the first question is whether a pitch was intentionally thrown at the batter. The rule does not apply in the absence of such intent. Whether the pitch was intentional or not is up to the umpire's judgment. In exercising their judgment, umpires are to be mindful that, given the skill level of most Major League pitchers, a pitch that is thrown at the head of a hitter more likely than not was thrown there intentionally. Umpires should bear this presumption in mind in deciding whether a pitch was intentional.

Once Rule 8.02(d) is found to be applicable (because an umpire has determined that, in the umpire's judgment, a pitch was intentionally thrown at a batter), an umpire has two options:

(1) Eject the pitcher, or the pitcher and his manager, from the game; or

(2) Warn the pitcher and the manager of both clubs that another such pitch will result in the immediate expulsion of that pitcher (or replacement) and the manager.

In other words, once an umpire has determined that a pitch thrown at a batter was intentional, the umpire must either warn or eject. Rule 8.02(d) does not give the umpire the discretion to allow the opposing pitcher an opportunity to retaliate in kind before the warning or ejection. Nor does the Rule mandate, even in an instance where a pitcher has intentionally thrown at the head of a hitter, that the pitcher must be ejected.

Which of the two options (warn or eject) is elected by the umpire under Rule 8.02(d) is at the discretion of the umpire, but the elected option is to be based on all the surrounding circumstances. In assessing those circumstances, the umpire is to take into account the Note to Rule 8.02(d), which states that pitching at a batter's head is unsportsmanlike, highly dangerous, and condemned within the sport.

Official Baseball Rule 8.02(d) additionally provides that if, in the umpire's judgment, circumstances warrant, both teams may be officially "warned" prior to the game or at any time during the game. Major League Baseball does not recommend that clubs be officially warned prior to a game except in the most extreme cases.

A report must be phoned in and filed with the Office of the Commissioner any time a warning is issued, giving all specifics of the incident. This is particularly important so that other crews may be advised of potential trouble via the Heads-Up program. (See Section XIV in Conduct and Responsibilities of Umpires.)

In the event a pitcher is removed from the game under Official Baseball Rule 8.02(d), the substitute pitcher should be allowed a sufficient number of pitches to warm up properly. (See Section 7.2.)