Rule 67:16:28:06 Payment for multiple procedures.
67:16:28:06. Payment for multiple procedures. If
one covered surgical procedure is performed in a single operative session,
payment is 100 percent of the established reimbursement rate. If more than one surgical procedure is
performed in a single operative session, the procedure with the highest
reimbursement rate is covered at 100 percent of the established rate and each
additional procedure is covered at 50 percent of the established reimbursement
rate.
Source: 11 SDR 86, effective December 30, 1984; 16 SDR 234,
effective July 2, 1990.
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.
Cross-Reference: Rate of payment, 42 C.F.R.
§ 416.120(c).
Back to
67:16:28 |
67:16:28:06 