S.D. Admin. R. 67:16:01:28

Current through Register Vol. 51, page 43, September 23, 2024
Section 67:16:01:28 - Rates and procedures subject to review and amendment - Provider may request review

Rates paid under the provisions of article 67:16 and posted on the department's website located HERE are subject to review and amendment by the department.

A provider may request that the department review a particular reimbursement rate for possible adjustment or request the inclusion or exclusion of a particular procedure code, item, or service for payment purposes. The request must be in writing. When reviewing a request, the department shall review paid claims information, Medicare fee schedules, national coding lists, and documentation submitted by the provider or the associated medical professional organization to determine whether a change is warranted. When the review is complete, the department shall notify the provider in writing of the results of the department's review.

S.D. Admin. R. 67:16:01:28

35 SDR 49, effective 9/10/2008.

General Authority: SDCL 28-6-1, 28-6-1.1.

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