New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-W - Former Division of Human Services
Chapter He-W 500 - MEDICAL ASSISTANCE
Part He-W 577 - LABORATORY SERVICES
Section He-W 577.07 - Payment for Services

Universal Citation: NH Admin Rules He-W 577.07

Current through Register No. 40, October 3, 2024

(a) Laboratory service providers shall bill:

(1) Utilizing the appropriate CPT code and code guidelines established for use with these procedure codes;

(2) For services referred to and provided by another laboratory in accordance with He-W 577.03(b) ; and

(3) For tests performed as groups and combinations utilizing the CPT codes for automated multichannel procedures.

(b) All laboratory tests shall be included in the panel if:

(1) A panel procedure code is utilized for billing; and

(2) The panel procedure code is listed in the National Correct Coding Initiative (NCCI), found at the Centers for Medicare and Medicaid Services, at www.cms.hhs.gov.

(c) Payments to laboratory service providers shall be made in accordance with rates established by the department pursuant to RSA 161:4, VI.

(d) The department shall directly reimburse a physician for laboratory services provided by a laboratory service provider with which the physician has a contract or agreement.

(e) Laboratory service providers shall submit claims for payment to the department's fiscal agent.

(f) Laboratory service providers shall maintain supporting documentation, in accordance with He-W 520.

#8564, eff 2-7-06; ss by #10513, eff 1-24-14

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