Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1150 - MA PROGRAM PAYMENT POLICIES
PAYMENT FOR SERVICES
Section 1150.55 - Obstetrical services
Universal Citation: 55 PA Code ยง 1150.55
Current through Register Vol. 54, No. 44, November 2, 2024
(a) The fee for a delivery includes:
(1) Antepartum
care provided on an inpatient basis.
(2) Inpatient and outpatient office or home
visits provided by the practitioner who performed the delivery, for a purpose
related to delivery, during the number of postpartum days specified in the
Medical Assistance Program Fee Schedule for each obstetrical procedure. During
this specified period, the practitioner who performed the delivery is eligible
to receive payment for treatment of a medical or surgical condition if the
diagnosis necessitating the treatment is different and unrelated to the
delivery.
(b) The practitioner performing the delivery may also bill for visits for care of the newborn if that practitioner is the responsible attending physician for the newborn.
(c) In addition to the practitioner performing the delivery, another practitioner may bill for stand-by services but only in the case of Cesarean sections or high risk deliveries. This is in lieu of billing for an initial visit.
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