South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:29 - Medical equipment
Section 67:16:29:09 - Billing requirements

Claims for medical equipment must be submitted at the provider's usual and customary charge. If it is the provider's custom to charge the general public for handling, delivery, and taxes, those charges may be included in the provider's usual and customary charge. A provider may not bill the department for equipment until the equipment has been delivered to the recipient.

A copy of the physician or other licensed practitioner's written prescription, the invoice showing the purchase price of the equipment, and other documentation does not need to be submitted with the claim unless required; however, it must be maintained by the provider in the recipient's clinical record and made available on request.

Covered equipment must be billed using the applicable procedure code contained in Health Care Common Procedure Coding System (HCPCS).

A provider may not submit claims that do not meet the criteria contained in this chapter.

A provider may not submit a claim for hearing aids until after thirty days of placement. A provider may not submit a claim if the hearing aids are returned during a trial period.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1(1)(2)(4), 28-6-1.1.

Claim requirements, § 67:16:29:11.

Use of Health Care Common Procedure Coding System, § 67:16:01:27.