Ala. Admin. Code r. 560-X-38-.01

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-38-.01 - General

(1) Ambulatory surgical services are those procedures typically performed on an inpatient basis which call be performed safely on an outpatient or ambulatory surgical center (ASC) basis.

(2) Ambulatory surgical center services shall be reimbursed by means of a predetermined fee established by the Alabama Medicaid Agency. All ambulatory surgical center procedures shall be reimbursed at the lesser of the predetermined rate for the procedure less the copay amount. The fee is established at levels estimated to approximate the costs incurred by providers generally in providing covered services.

(3) Ambulatory surgical center services shall be limited to three (3) visits per calendar year.

Author:

Ala. Admin. Code r. 560-X-38-.01

Rule effective September 1, 1986.

Statutory Authority:42 C.F.R. §§ 416.2, 416.39, 416.40.