Rule 67:16:03:06.13 Items and services not included in reimbursement rate for outpatient surgical services covered under chapter 67:16:28 and paid under the provisions of chapter 67:16:03.
67:16:03:06.13. Items and services not included in reimbursement
rate for outpatient surgical services covered under chapter 67:16:28 and paid
under the provisions of chapter 67:16:03. Outpatient surgical services
covered under § 67:16:28:04 and reimbursed under this chapter do not
include items and services for which payment may be made under other provisions
of this article, such as physician services, certified registered nurse
anesthetist services, laboratory services, X ray or imaging procedures, prosthetic
devices, ambulance services, orthotic devices, recovery and observation room
charges if the patient is required to stay in excess of 12 hours after the
completion of the surgical procedure, and durable medical equipment for use in
the patient's home, unless they are specifically included under
23 SDR 232, effective July 10, 1997; 35 SDR 49, effective September 10, 2008.
Authority: SDCL 28-6-1.
Implemented: SDCL 28-6-1.
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