S.D. Admin. R. 67:16:06:04

Current through Register Vol. 51, page 57, November 12, 2024
Section 67:16:06:04 - Covered services - Limits - Rate of payment

Covered dental services include, at a minimum, those procedures and limitations contained on the department's fee schedule website.

The rate of payment is limited to the lesser of the provider's usual and customary fee or the fee contained on the department's fee schedule website.

The rates of payment are subject to review and amendment by the department under the provisions of § 67:16:01:28.

The covered items and services provided under this chapter for children under the age of 21 are not subject to the established limits.

Coverage for nonemergency adult dental services is limited to $ 2,000 per state fiscal year.

S.D. Admin. R. 67:16:06:04

SL 1975, ch 16; 42 SDR 51, effective 10/13/2015; 49 SDR 021, effective 9/12/2022

General Authority: SDCL 28-6-1(1)(2).

Law Implemented: SDCL 28-6-1, 28-6-1.1.

Eligibility requirements, § 67:46:01:02. Qualified Medicare Beneficiaries (QMB), ch 67:46:11. Fee Schulte Website Definition, § 67:16:01:01(18).