Section 405 IAC 5-26-7 - Podiatric office visitsAuthority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3
Affected: IC 12-13-7-3; IC 12-15
Sec. 7.
(a) Medicaid reimbursement is available for podiatric office visits, subject to the following restrictions:(1) Reimbursement is limited to one (1) office visit per twelve (12) months, per member.(2) New patient office visits are limited to one (1) per member, per provider, within the last three (3) years. As used in this subdivision, "new patient" is one who has not received professional services from the provider or another provider of the same specialty who belongs to the same group practice within the past three (3) years.(3) A visit may be billed separately only on the initial visit. For subsequent visits, a visit may be billed only if a significant additional problem is addressed.(b) Reimbursement is not available for the following types of extended or comprehensive office visits: (1) New patient comprehensive.(2) Established patient detailed.(3) Established patient comprehensive.Office ofthe Secretary of Family and Social Services; 405 IAC 5-26-7; filed Jul 25, 1997, 4:00p.m.: 20 IR 3349; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFAFiled 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRAReadopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFAReadopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA