Section 17b-262-649 - Payment(a) Payment shall be made at the lowest of: (1) the provider's usual and customary charge to the general public;(2) the lowest Medicare rate;(3) the amount in the applicable fee schedule as published by the department;(4) the amount billed by the provider; or(5) the lowest price charged or accepted for the same or substantially similar goods or services by the provider from any person or entity.(b) Notwithstanding the provisions of subsection (a) of this section and subject to the approval of the department, a provider may charge or accept a lesser amount based on a showing by the provider of financial hardship to an individual enrollee without affecting the amount paid by the department for the same or substantially similar goods or services.(c)Payment RateThe commissioner establishes the fees contained in the department's published fee schedule for independent clinical laboratories pursuant to section 4-67c of the Connecticut General Statutes.
(d)Payment Limitations(1) A specimen collection fee by an independent clinical laboratory is limited to specimen collection by venipuncture or catherization.(2) One specimen collection fee is permitted per encounter. A physician or duly authorized practitioner of the healing arts shall order the collection, and the order shall include the covered procedure or procedures from the independent clinical laboratory fee schedule. Payment shall be made to the provider performing the collection.Conn. Agencies Regs. § 17b-262-649
Adopted effective May 10, 2000