N.Y. Comp. Codes R. & Regs. tit. 14 § 679.5

Current through Register Vol. 46, No. 45, November 2, 2024

Section 679.5 - Units of service-definitions and restrictions

(a) The unit of service shall be a clinic visit as defined below whether the service is delivered at the main certified site, or at a certified satellite site or, prior to April 1, 2016, off-site.

(b) A clinic visit is or defined as all the approved clinical services provided for a person, his/her collateral or potential admittee on a common date of service by practitioners of the healing arts and/or other authorized parties, except as follows:

(1) If a diagnostic and evaluation service is conducted over more than one day, the date of service for claiming purposes is the last day the service is provided.

(2) If an on-site clinic visit is provided and claimed for reimbursement on the same day as an off-site clinic visit (as allowed prior to April 1, 2016), reimbursement for each visit is considered a separate clinic visit.

(c) A clinic visit may include face-to-face service as define d by allow- able Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) and/or Current Dental Terminology (CDT) codes, or such allowable services provided via telehealth.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 679.5

Amended New York State Register March 30, 2016/Volume XXXVIII, Issue 13, eff.4/1/2016

Amended New York State Register April 20, 2016/Volume XXXVIII, Issue 16, eff.4/20/2016

Amended New York State Register September 21, 2016/Volume XXXVIII, Issue 38, eff. 9/21/2016

Amended New York State Register December 12, 2018/Volume XL, Issue 50, eff. 12/12/2018