South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:03 - Hospital services
Section 67:16:03:06.07 - Reimbursement of outpatient laboratory services

Except for Medicare prospective payment system hospitals, outpatient laboratory services are reimbursed according to the outpatient laboratory fee schedule located on the department's fee schedule website. If no fee for a procedure is established, reimbursement is 60 percent of the actual charge for the service.

The laboratory services and associated rates of payment are subject to review and amendment under the provisions of § 67:16:01:28.

Costs for outpatient laboratory services incurred within three days immediately preceding an inpatient stay are included in the inpatient charges unless the outpatient laboratory service is not related to the inpatient stay. This provision applies only if the facilities providing the services are owned by the same entity.

General Authority: SDCL 28-6-1(2), 28-6-1.1.

Law Implemented: SDCL 28-6-1(2), 28-6-1.1.