S.D. Admin. R. 67:16:09:05.01

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:16:09:05.01 - Rate of payment

Payment for chiropractic services is limited to the lesser of the provider's usual and customary charge or the fee contained on the department's fee schedule website.

Manual manipulation of the spine is limited to one treatment a day and 30 treatments in each 12 month period, in any combination of the codes 98940, 98941, or 98942.

The rates of payment are subject to review and amendment by the department. A provider may request that the department review a particular reimbursement rate for possible adjustment or request the inclusion or exclusion of a particular code from the list. When reviewing the requests, the department shall review paid claims information, Medicare fee schedules, national coding lists, and documentation submitted by the provider or the associated medical professional organization to determine whether a change is warranted.

S.D. Admin. R. 67:16:09:05.01

16 SDR 227, effective 6/24/1990; 17 SDR 200, effective 7/1/1991; 18 SDR 135, effective 2/25/1992; 20 SDR 49, effective 10/14/1993; 20 SDR 135, effective 2/22/1994; 21 SDR 68, effective 10/13/1994; 33 SDR 137, effective 3/7/2007; 42 SDR 51, effective 10/13/2015

General Authority: SDCL 28-6-1.

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