048-17 Wyo. Code R. § 17-4

Current through April 27, 2019
Section 17-4 - Reimbursement for Services

Pursuant to W.S. § 35-25-204, the WCCSP will reimburse providers for the costs relating to colonoscopy screening. If a colonoscopy screening is unsuccessful and cannot be completed, an alternate screening method will be considered for reimbursement on a case-by-case basis as determined by the Department's staff physician.

(a) Services covered by the WCCSP. Reimbmrsement is paid for services listed on the program's CPT code list. The CPT-code list is located on the program's web site.

(b) Services not covered by the WCCSP.

  • (i) There will be no reimbursement to providers for colonoscopies or related costs performed prior to the WCCSP enrollment start date. The applicant/patient must have a WCCSP payment voucher to present to the provider prior to the procedure, unless otherwise approved by WCCSP. If applicant/patient does not have proper enrollment approval, the applicant/patient will assume responsibility for any costs relating to procedures performed prior to enrollment approval,
  • (ii) Reimbursement for adverse events is not covered by the WCCSP.
  • (iii) The WCCSP shall not reimburse for follow-up surgery or additional care needed if an actual cancer or other condition requiring additional medical care is found.

048-17 Wyo. Code R. § 17-4