Section 17b-262-519 - Payment rate and limitations(a) The commissioner shall establish the fees contained in the department's published fee schedule for independent radiology and ultrasound centers pursuant to section 4-67c of the Connecticut General Statutes.(b) The payment rate 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.(c) When emergency services are rendered after normal posted business hours, a fee as indicated on the provider's fee schedule shall be reimbursed to the provider per patient.(d) Actual allowable procedures billable to the Medical Assistance Program are negotiated individually by provider.Conn. Agencies Regs. § 17b-262-519
Adopted effective March 6, 1998