Indiana Code 12-15-15-2.5. Payment for physician services in emergency department
Current as of: 2023 | Check for updates
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Sec. 2.5. (a) Payment for physician services provided in the emergency department of a hospital licensed under IC 16-21 must be at a rate of one hundred percent (100%) of rates payable under the Medicaid fee structure.
(c) For services rendered and documented in an individual’s medical record, physicians must be reimbursed for federally required medical screening exams that are necessary to determine the presence of an emergency using the appropriate Current Procedural Terminology (CPT) codes 99281, 99282, or 99283 described in the Current Procedural Terminology Manual published annually by the American Medical Association, without authorization by the enrollee’s primary medical provider.
(b) The payment under subsection (a) must be calculated using the same methodology used for all other physicians participating in the Medicaid program.
Terms Used In Indiana Code 12-15-15-2.5
- medical record: means written or printed information possessed by a provider (as defined in Ind. See Indiana Code 1-1-4-5
(d) This section does not apply to a person enrolled in a Medicaid risk based managed care program.
As added by P.L.153-1995, SEC.10. Amended by P.L.119-1997, SEC.5; P.L.245-1999, SEC.1; P.L.223-2001, SEC.10; P.L.152-2017, SEC.23.