4123-6-37.3 Payment of ambulatory surgical center services.  

  • Text Box: ACTION: Final Text Box: DATE: 04/20/2016 12:11 PM

     

     

     

    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, 2015 2016 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, 2015 2016.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    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