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1,256 sections in this chapter.
R.23-216-1.3 Bundled ESRD PPS Rate
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A. The Division of Medicaid reimburses ESRD facilities the bundled ESRD PPS rate effective as of January 1, of each year. B. The ESRD PPS rate provides a single payment for all resources used in providing dialysis services including supplies, equipment, drugs, biologicals, labora…
R.23-216-1.4 Professional Services
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A. The Division of Medicaid covers related physician services for ESRD billed with the appropriate procedure codes which are excluded from the ESRD PPS rate. 1. The physician or qualified health care professional must provide one (1) face-to-face visit with the beneficiary monthl…
R.23-216-1.5 Documentation Requirements
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A. Dialysis providers must maintain auditable records that substantiate the dialysis services provided. B. The physician or qualified healthcare professional's documentation in the medical record must include, but is not limited to, the following: 1. Dates of service, 2. Monthly …