S.D. Admin. R. 67:16:25:08.01

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

Section 67:16:25:08.01 - Billing requirements - Secure medical transportation

A claim for secure medical transportation service must be submitted at the provider's usual and customary charge.

A provider may bill for services only if a recipient has been transported. A provider may not bill for any portion of a secure medical transportation service during which the recipient was not physically present in the secure medical transportation vehicle.

A provider may not submit a claim for in-town mileage. If an extra patient was transported with the recipient, the provider must add the modifier "TK" to the procedure code being billed. If a hospital arranged for the transfer, the provider must add the modifier "QM" to the procedure code being billed.

S.D. Admin. R. 67:16:25:08.01

16 SDR 234, effective 7/1/1990; 17 SDR 4, effective 7/16/1990; 20 SDR 214, effective 6/20/1994; 35 SDR 253, effective 5/12/2009; 44 SDR 94, effective 12/4/2017

General Authority: SDCL 28-6-1

Law Implemented: SDCL 28-6-1(1)(2)(4)

Third-party liability, ch 67:16:26.