907 KAR 1:029. Payments for other laboratory and x-ray services.

      RELATES TO: KRS 205.520

      STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 42 C.F.R. 440.30, 493, 42 U.S.C. 1396(d), EO 2004-726

      NECESSITY, FUNCTION, AND CONFORMITY: EO 2004-726, effective July 9, 2004, reorganized the Cabinet for Health Services and placed the Department for Medicaid Services and the Medicaid Program under the Cabinet for Health and Family Services. The Cabinet for Health and Family Services has responsibility to administer the Medicaid Program. KRS 205.520 empowers the cabinet, by administrative regulation, to comply with any requirement that may be imposed, or opportunity presented, by federal law for the provision of medical assistance to Kentucky's indigent citizenry. This administrative regulation sets forth the method of determining amounts payable by the cabinet for other laboratory and x-ray services.

      Section 1. Laboratory Services. The cabinet shall reimburse participating independent laboratories, outpatient surgical clinics, renal dialysis centers, and outpatient hospital clinics for covered services rendered on the basis of the allowable payment rates set by Medicare.

      Section 2. X-ray Services. Covered x-ray services (radiological services) provided to eligible Medicaid recipients in accordance with the limitations described in 907 KAR 1:028 shall be paid for at usual and customary charges up to sixty (60) percent of the fixed upper limit per procedure for physicians.

      Section 3. The amendments to Section 2 of this administrative regulation shall be effective with regard to services provided on or after December 1, 1992. (Recodified from 904 KAR 1:029, 5-2-86; Am. 15 Ky.R. 678; eff. 9-21-88; 19 Ky.R. 2147; eff. 4-21-93.)