South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:44 - Federally qualified health centers and rural health clinics
Section 67:16:44:06 - Rate of payment

Payment is made at an all-inclusive rate for each visit for covered services. The department follows the standards established by the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000, Title II, § 702 (114 Stat. 2763A-572), as amended to July 1, 2019, to determine a facility's rate of payment.

In the absence of specific regulations relating to allowable costs, the department bases allowable cost decisions on the Medicare Provider Reimbursement Manual (CMS Pub. 15-1), as specified in § 67:16:04:62.

Covered services that are not reimbursed as part of the all-inclusive rate will be reimbursed at the applicable medical assistance reimbursement methodology for the service.

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

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

Definition of rural primary care hospital, SDCL 34-12-1.1.