Kentucky Administrative Regulations
Title 907 - CABINET FOR HEALTH AND FAMILY SERVICES - DEPARTMENT FOR MEDICAID SERVICES
Chapter 1 - Medicaid Services
Section 907 KAR 1:049 - Payments for family planning services

Universal Citation: 907 KY Admin Regs Service 1:049

Current through Register Vol. 50, No. 9, March 1, 2024

RELATES TO: KRS 205.520

NECESSITY, FUNCTION, AND CONFORMITY: The Cabinet for Human Resources has responsibility to administer the program of Medical Assistance. 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 for determining amounts payable by the cabinet for family planning services.

Section 1. Family Planning Clinics. The cabinet shall reimburse family planning clinics or agencies for covered services on the basis of a flat fee schedule.

Section 2. Amount of Payment. Reimbursement in accordance with the flat fee schedule shall be at the following rates:

(1) For services provided by a physician: initial clinic visit, fifty (50) dollars; annual clinic visit, sixty (60) dollars; follow-up visit with pelvic examination, twenty-five (25) dollars; and follow-up visit without pelvic examination, twenty (20) dollars.

(2) For services provided by an advanced registered nurse practitioner with appropriate training as specified by the cabinet: initial clinic visit, thirty-seven (37) dollars and seventy-five (75) cents; annual clinic visit, forty-five (45) dollars; follow-up visit with pelvic examination, eighteen (18) dollars and seventy-five (75) cents; and follow-up visit without pelvic examination, fifteen (15) dollars.

(3) The fee for the counseling visit shall be thirteen (13) dollars; for a counseling visit with three (3) months contraceptive supply the fee shall be seventeen (17) dollars; for a counseling visit with six (6) months contraceptive supply the fee shall be twenty (20) dollars; for a supply only visit, the fee shall be the actual acquisition cost of contraceptive supplies dispensed. The supply only visit fee shall not be paid as an addition to a fee for another type of visit, since the fee for other types of visits includes an amount for contraceptives.

STATUTORY AUTHORITY: KRS 194.050, 42 C.F.R. 447 Subpart B, 42 U.S.C. 1396a, b, d

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