Yes. Similarly you can eliminate tu just like in Spanish. Mă urmărești is enough information to infer who is following and who is followed.
It's exactly like in Spanish: (Tu) mă urmărești (pe mine)? = ¿(Tú) me sigues (a mí)?.
Does it mean both the ways we use it in English: "Are you walking behind me ?" and "Are you understanding what I'm saying ?"
I would guess it is more to do with the English verb being continuous, rather than the use of 'are'.
To come at it from a different angle, you can't say 'are you follow me' in English.
The Romanian verb may take a different form for the continuous, though I can't say for sure as I haven't got that far in my learning and do not know anything about 'continuous' forms in Romanian, or if it is even expressed through changing the form of the verb.