S.D. Admin. R. 67:16:02:16.01
When computing the rate of reimbursement, the department uses the fee schedules established under the provisions of § 67:16:02:01.01. A claim submitted under this chapter for covered implantable contraceptive capsules and obstetrical services must be submitted at the provider's usual and customary charge and is limited to the nonlaboratory procedure codes listed in the applicable fee schedule.
A claim submitted for insertion or reinsertion, implantable contraceptive capsule may not include the cost of the kit. The kit must be billed separately.
Providers must use the appropriate CPT code to indicate obstetric care, antepartum care, delivery, and postpartum care. When applicable, providers must bill using the global delivery codes defined on the department's billing guidance website. A provider may not separate claims for antepartum care, delivery services, or postpartum care when using a global delivery code.
A claim submitted for postpartum care is limited to hospital and office visits in the 60 days following vaginal or cesarean section delivery.
The guidelines adopted in § 67:16:01:25 apply unless otherwise noted in this chapter.
S.D. Admin. R. 67:16:02:16.01
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.