S.D. Admin. R. 67:16:02:01.01

Current through Register Vol. 50, page 162, June 24, 2024

Section 67:16:02:01.01 - Fee schedules for physician services

Fee schedules for services provided under this chapter are available on the department's fee schedule website. When computing the rate of reimbursement for physician services, the department uses the following fee schedules:

(1) Nonlaboratory fee schedule; and

(2) Laboratory fee schedule.

The fee schedules 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 code from the list. When reviewing the requests, 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.

S.D. Admin. R. 67:16:02:01.01

34 SDR 68, effective 9/12/2007; 42 SDR 51, effective 10/13/2015; 44 SDR 94, effective 12/4/2017

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1(1)(2), 28-6-1.1.