New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter B - Property and Casualty Insurance
Part 68 - Charges For Professional Health Services
Section 68.4 - Exception to limitations

Current through Register Vol. 46, No. 12, March 20, 2024

A charge in excess of the scheduled fee may be authorized by the insurer, the arbitrator of disputes involving health services or a court of competent jurisdiction, if such insurer, arbitrator or court finds that an unusual procedure or unique circumstance justifies the necessity for such charge. This exception to the fee schedule limitations shall not apply to charges for hospital inpatient services subject to a per diem rate in the hospital fee schedule.

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