4123-6-37.3 Payment of ambulatory surgical center services.
Unless an MCO has negotiated a different payment rate with an ambulatory surgical center pursuant to rule 4123-6-08 of the Administrative Code, reimbursement for ambulatory surgical center services with a date of service of May 1,
20152016 or after shall be equal to the lesser of the ambulatory surgical center's allowable billed charges or the fee schedule amount indicated in appendix A to this rule, developed with provider and employer input and effective May 1,20152016.4123-6-37.3 2
Effective: 05/01/2016
Five Year Review (FYR) Dates: 02/01/2020
CERTIFIED ELECTRONICALLY
Certification
04/20/2016
Date
Promulgated Under: 119.03
Statutory Authority: 4121.12 , 4121.121 , 4121.30, 4121.31 , 4123.05
Rule Amplifies: 4121.12, 4121.121 , 4121.44 , 4121.441 , 4123.66
Prior Effective Dates: 4/1/09, 4/1/10, 4/1/11, 4/1/12, 4/1/13, 5/5/14, 5/1/15
Document Information
- Effective Date:
- 5/1/2016
- File Date:
- 2016-04-20
- Last Day in Effect:
- 2016-05-01
- Rule File:
- 4123-6-37$3_PH_FF_A_RU_20160420_1211.pdf
- Related Chapter/Rule NO.: (1)
- Ill. Adm. Code 4123-6-37.3. Payment of ambulatory surgical center services