La. Admin. Code tit. 50 § XV-7321

Current through Register Vol. 50, No. 11, November 20, 2024

Section XV-7321 - Reimbursement

A. Reimbursement for EPSDT PCS shall be the lesser of billed charges or the maximum unit rate set by the department. The maximum rate is a flat rate for each approved unit of service provided to the beneficiary. This rate shall be adjusted as necessary by the department.

1. One quarter hour (15 minutes) is the standard unit of service, exclusive of travel time to arrive at the beneficiary's home.

2. The entire 15 minutes shall have been spent providing personal care services in order to be reimbursed for a unit.

B. Repealed.

La. Admin. Code tit. 50, § XV-7321

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 29:179 (February 2003), amended LR 33:2202 (October 2007), repromulgated LR 33:2425 (November 2007), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:2561 (November 2010), Amended by the Department of Health, Bureau of Health Services Financing, LR 45908 (7/1/2019), Amended LR 49262 (2/1/2023).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.