New York Codes, Rules and Regulations
Chapter II - Regulations of the Department of Social Services
Subchapter E - Medical Care
Article 4 - Fees and Reimbursement
Part 532 - Payment To Physicians
Section 532.1 - Fees

Current through Register Vol. 45, No. 13, March 29, 2023

(a) Payment for scheduled services. Social services districts shall establish fees for the services and procedures listed in Part 533. The schedule of such fees shall be classified as "Medicine", "Anesthesia", "Surgery" and "Radiology" and shall be included in the local medical plan.

(b) Payment for nonscheduled services. If a service or procedure not included in the fee schedule established pursuant to subdivision (a) of this section has been or is required to be rendered, the value therefor shall be established by the social services district, utilizing the most closely related procedures listed in the fee schedule as a base. The fee so established shall be reported promptly to the department and to the Division of Health Economics of the State Department of Health.

(c) State reimbursement for payments to physicians under the Medical Assistance for Needy Persons program shall be available only for services rendered by a physician meeting the qualifications for general practitioners and specialists as set forth in Part 505 of the regulations of the department, or by a registered physician's associate or a registered specialist's assistant employed by such physician.

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