Section 17b-262-460 - 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 of substantially similar goods or services by the provider from any person or entity.(b) A psychiatrist who is fully or partially salaried by a general hospital, public or private institution, physicians' group, or clinic shall not receive payment from the department unless the psychiatrist maintains an office for private practice at a location separate from the hospital, institution, physicians' group, or clinic in which the psychiatrist is employed. Psychiatrists who are solely hospital, institution, physicians' group, or clinic-based, either on a full- or part-time salary are not entitled to payment from the department for services rendered to Medical Assistance Program clients.(c) A psychiatrist who maintains an office for private practice separate from the hospital, institution, physicians' group, or clinic shall be able to bill for services provided at the private practice location or for services provided to the psychiatrist's private practice clients in the hospital, institution, physicians' group, or clinic only if the client is not a patient of the hospital, institution, physicians' group, or clinic.Conn. Agencies Regs. § 17b-262-460
Adopted effective May 11, 1998