Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1143 - PODIATRISTS' SERVICES
PAYMENT FOR PODIATRISTS' SERVICES
Section 1143.57 - Limitations on payment

Universal Citation: 55 PA Code ยง 1143.57

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

The following limits apply to payment for compensable services:

(1) Payment for office visit for podiatric services is limited to the podiatrist's usual charge to the general public, not to exceed the maximum allowable payment established in Chapter 1150 (relating to MA Program payment policies) and the MA Program fee schedule.

(2) Payment is made to only one podiatrist for a particular service or procedure and services shall be billed in the name of the podiatrist providing the service.

(3) Payment for X-rays taken in the podiatrist's office during the course of a treatment is limited to the maximum fee per limb specified in the MA Program fee schedule, in addition to the visit fee.

This section cited in 55 Pa. Code § 1143.51 (relating to general payment policy); and 55 Pa. Code § 1143.52 (relating to payment conditions for various services).

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