Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 8 - HEARING AIDS
Section 471-8-005 - BILLING AND PAYMENT FOR HEARING AIDS
Universal Citation: 471 NE Admin Rules and Regs ch 8 ยง 005
Current through March 20, 2024
005.01 BILLING.
005.01(A)
GENERAL BILLING REQUIREMENTS. Providers must comply
with all applicable billing requirements codified in 471 NAC 3. In the event
that individual billing requirements in 471 NAC 3 conflict with billing
requirements outlined in this chapter, the individual billing requirements in
this chapter will govern.
005.01(B)
SPECIFIC BILLING REQUIREMENTS. Providers must submit
claims to the Department on the appropriate claim form or electronic format.
The provider or the provider's authorized agent must submit the provider's
usual and customary charge for each procedure code listed on the claim.
005.01(B)(i)
PROCEDURE
CODES. Healthcare Common Procedure Coding System (HCPCS) and
Current Procedural Terminology (CPT) procedure codes used by Medicaid are
listed in the Nebraska Medicaid Practitioner Fee Schedule.
005.02 PAYMENT.
005.02(A)
GENERAL PAYMENT REQUIREMENTS. Medicaid will reimburse
the provider for services rendered in accordance with the applicable payment
regulations codified in 471 NAC 3. In the event that individual payment
regulations in 471 NAC 3 conflict with payment regulations outlined in this
chapter, the individual payment regulations in this chapter will
govern.
005.02(B)
SPECIFIC PAYMENT REQUIREMENTS. Medicaid pays for
covered hearing aid services at the lower of:
(i) The provider's submitted charge;
or
(ii) The allowable amount for
that procedure code in the Nebraska Medicaid Practitioner Fee Schedule for that
date of service.
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