67:16:06:04.  Covered services -- Limits -- Rate of payment. Covered dental services include, at a minimum, those procedures and limitations contained on the department's website located at http://www.dss.sd.gov/medicalservices/providerinfo/feeschedule.asp.

 

          The rate of payment is limited to the lesser of the provider's usual and customary fee or the fee contained on the department's website located at http://www.dss.sd.gov/medicalservices/providerinfo/feeschedule.asp.

 

          The rates of payment are subject to review and amendment by the department under the provisions of § 67:16:01:28.

 

          The covered items and services provided under this chapter for children under the age of 21 are not subject to the established limits.

 

          Coverage for nonemergency adult dental services is limited to $1,000 per state fiscal year.

 

          Source: SL 1975, ch 16, § 1; 1 SDR 66, effective April 6, 1975; 4 SDR 10, effective August 28, 1977; 4 SDR 35, effective December 22, 1977; 4 SDR 88, effective June 26, 1978; 7 SDR 23, effective September 18, 1980; 7 SDR 66, 7 SDR 89, effective July 1, 1981; 11 SDR 26, effective August 21, 1984; 12 SDR 70, effective October 31, 1985; 15 SDR 167, effective May 11, 1989; 16 SDR 234, effective July 1, 1990; 18 SDR 198, effective June 3, 1992; 23 SDR 197, effective May 26, 1997; 35 SDR 88, effective October 23, 2008; 38 SDR 224, effective July 1, 2012.

          General Authority: SDCL 28-6-1.

          Law Implemented: SDCL 28-6-1, 28-6-1.1.

 

          Cross-References:

          Eligibility requirements, § 67:16:01:02.

          Qualified Medicare beneficiary, ch 67:16:30.