Regulation .06 Payment Rates.
Regulation .06 Payment Rates.LinkCopy Citation
The Department shall pay:
A.
Hospitals, at rates approved by the Health Services Cost Review Commission;
B.
Physicians, the lesser of the:
(1)
Amount billed; or
(2)
The Statewide average of prevailing charges for an examination by a physician consultant based on Medicare's 75th percentile as determined according to 42 CFR Sec. 405.504; and
C.
Transportation providers, if transportation is by:
(1)
Ambulance, the lesser of the:
(a)
Amount billed; or
(b)
The Statewide average of prevailing charges for an ambulance based on Medicare's 75th percentile; or
(2)
A law enforcement officer in an emergency vehicle:
(a)
The cost per mile based on the county's established rates for emergency vehicles; and
(b)
The cost of the law enforcement officer's hourly wage for the number of hours, not to exceed 4 hours, required to transport the emergency evaluee.