La. Admin. Code tit. 50 § XIX-4334
Current through Register Vol. 50, No. 11, November 20, 2024
Section XIX-4334 - Radiology Services Reimbursement MethodologyA. This reimbursement methodology applies to radiology services including portable x-ray and radiation therapy center services.B. Providers shall be reimbursed according to the established fee schedule or billed charges, whichever is the lesser amount.C. For newly added radiology services, the Medicaid fee shall be set at 75 percent of the current year-us Louisiana Region 99 Medicare allowable fee. 1. In the absence of a Medicare fee, the fee shall be set at the Medicaid fee for a similar service or the Medicaid fee for other states. In the absence of a similar service or a Medicaid fee for other states, the fee shall be set at the cost of performing the service.E. Effective for dates of service on or after February 26, 2009, the reimbursement rates for radiology services shall be reduced by 3.5 percent of the fee amounts on file as of February 25, 2009.F. Effective for dates of service on or after August 4, 2009, the reimbursement rates for radiology services shall be reduced by 4.7 percent of the fee amounts on file as of August 3, 2009. G . Effective for dates of service on or after January 22, 2010, the reimbursement rates for radiology services shall be reduced by 4.42 percent of the fee amounts on file as of January 21, 2010. H. Effective for dates of service on or after August 1, 2010, the reimbursement rates for radiology services shall be reduced by 4.6 percent of the fee amounts on file as of July 31, 2010. I. Effective for dates of service on or after January 1, 2011, the reimbursement rates for radiology services shall be reduced by 2 percent of the fee amounts on file as of December 31, 2010. La. Admin. Code tit. 50, § XIX-4334
Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 35:1897 (September 2009), amended LR 36:1248 (June 2010), LR 36:2563 (November 2010), LR 37:3029 (October 2011), LR 39:1284 (May 2013), LR 41:539 (March 2015), Amended by the Department of Health, Bureau of Health Services Financing, LR 44283 (2/1/2018), Amended by the Department of Health, Bureau of Health Services Financing, LR 47252 (2/1/2021), Amended LR 471638 (11/1/2021).AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.