Pennsylvania Code
Title 31 - INSURANCE
Part II - Automobile Insurance
Chapter 69 - MOTOR VEHICLE FINANCIAL RESPONSIBILITY LAW
Subchapter A - AUTOMOBILE INSURANCE MEDICAL COST CONTAINMENT
PROVIDER BILLING
Section 69.24 - Unbundling
Universal Citation: 31 PA Code ยง 69.24
Current through Register Vol. 54, No. 44, November 2, 2024
A provider may not fragment or unbundle charges imposed for specific care except as consistent with the Medicare Program. Changes to a provider's codes by an insurer shall be made only as consistent with the Medicare Program and when the insurer has sufficient information to make the changes and following consultation with the provider. An insurer shall substantiate the reasons for coding changes to the provider in writing.
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