405 Ind. Admin. Code 5-16.5-3

Current through January 8, 2025

Section 405 IAC 5-16.5-3 - Reimbursement

Authority: IC 12-8-6.5-5; IC 12-15

Affected: IC 12-13-7-2

Sec. 3.

(a) Covered freestanding birthing center services shall be reimbursed in accordance with this section.

(1) Services, including prenatal labor and delivery, that would otherwise be performed in a hospital setting shall be reimbursed to a freestanding birthing center at a flat rate determined by the office.

(2) A labor management fee when the patient is transferred to a hospital before the delivery is completed shall be paid to a freestanding birthing center at a flat rate determined by the office.

(3) The services of physicians and certified nurse midwives shall be reimbursed in accordance with 405 IAC 1-11.5.

(b) Medicaid reimbursement is available to a freestanding birthing center for services provided to members subject to the limitations in this rule and 410 IAC 27.

405 IAC 5-16.5-3

Office of the Secretary of Family and Social Services; 405 IAC 5-16.5-3; filed Nov 19, 2013, 2:11 p.m.: 20131218-IR-405120004FRA

Filed 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRA

Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA

Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA