Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-38 - AMBULATORY SURGICAL CENTER SERVICES
Section 560-X-38-.06 - Surgical Procedures Groups

Universal Citation: AL Admin Code R 560-X-38-.06
Current through Register Vol. 43, No. 02, November 27, 2024

The surgical procedures shall be classified into separate payment groups. All procedures within the same payment group are reimbursed at a single rate. These rates are subject to adjustment by the Alabama Medicaid Agency. The group payment amount is lowest for Group One procedures and highest for Group Nine. A provider shall receive the lesser of the submitted charge or the designated group charge less the copay amount.

Author: Solomon Williams, Associate Director, Insitutional Services, Managed Care Division

Statutory Authority: State Plan, Attachment 3-A; 42 C.F.R. §§405.310, 416.65.

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