Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1101 - GENERAL PROVISIONS
FEES AND PAYMENTS
Section 1101.66 - Payment for rendered, prescribed or ordered services

Universal Citation: 55 PA Code ยง 1101.66

Current through Register Vol. 54, No. 44, November 2, 2024

(a) The Department pays for compensable services or items rendered, prescribed or ordered by a practitioner or provider if the service or item is:

(1) Within the practitioner's scope of practice.

(2) Medically necessary.

(3) Not in an amount that exceeds the recipient's needs.

(4) Not ordered or prescribed solely for the recipient's convenience.

(5) Ordered with the recipient's knowledge.

(b) Prescriptions and orders shall be written, except telephoned prescriptions addressed in subsection (c). The written prescriptions and orders shall contain the practitioner's:

(1) Printed name.

(2) Signature.

(3) Professional license number.

(c) A practitioner may telephone a drug prescription to a pharmacist in accordance with the Pharmacy Act (63 P. S. §§ 390-1-390-13). The pharmacist shall:

(1) Record the complete prescription on a standard prescription form.

(2) Keep the recorded prescription on file.

(d) The practitioner's signature on the prescription is waived only for a telephoned drug prescription.

(e) Payment is not made for services or items rendered, prescribed or ordered by providers who have been terminated from the Medical Assistance program.

This section cited in 55 Pa. Code § 1101.66a (relating to clarification of the terms "written" and "signature"-statement of policy).

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