S.D. Admin. R. 67:16:03:06.07

Current through Register Vol. 51, page 43, September 23, 2024

Section 67:16:03:06.07 - Reimbursement of outpatient laboratory services

Except for Medicare prospective payment system hospitals, outpatient laboratory services are reimbursed according to the outpatient laboratory fee schedule located on the department's fee schedule website. If no fee for a procedure is established, reimbursement is 60 percent of the actual charge for the service.

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

Costs for outpatient laboratory services incurred within three days immediately preceding an inpatient stay are included in the inpatient charges unless the outpatient laboratory service is not related to the inpatient stay. This provision applies only if the facilities providing the services are owned by the same entity.

S.D. Admin. R. 67:16:03:06.07

17 SDR 180, effective 5/27/1991; 24 SDR 144, April 30, 1998; 30 SDR 26, effective 9/3/2003; 35 SDR 49, effective 9/10/2008; 37 SDR 236, effective 6/28/2011; 37 SDR 236, adopted June 8, 2010, effective 7/1/2012; 42 SDR 51, effective 10/13/2015; 43 SDR 80, effective 12/5/2016

General Authority: SDCL 28-6-1(2), 28-6-1.1.

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