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Payment for Portable Imaging Services.

22 CCR 51531

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22 CCR 51531

22 CCR 51531

§ 51531. Payment for Portable Imaging Services.

(a)

Payment for portable imaging services, when provided at home, in residential care facilities, in intermediate care facilities or in skilled nursing facilities, and done by or under the direction of a physician, may be made when billed by the physician, except when these services are included in the cost payment formula of a skilled nursing facility.

(b)

Payment for portable imaging services performed by a portable imaging services provider, in accordance with Sections 51193.1 and 51311(b), when provided at home, in residential care facilities, in intermediate care facilities or in skilled nursing facilities may be made in accordance with the following:

(1)

Payment for portable imaging services shall be reasonable charges not to exceed the charge in the locality for similar services with consideration for customary charges. Services shall be billed by the interpreting physician and/or the portable imaging services provider. In no event shall the charge exceed the charge made to the general public.

(2)

Payment for portable imaging services transportation shall include transportation of portable imaging equipment and personnel to the home or skilled nursing facility. Maximum reimbursement rates shall be established pursuant to Welfare and Institutions Code Section 14105.23.

(c)

Claims for services rendered by a portable imaging services provider shall include the name and address of the portable imaging services provider and ordering provider, the tentative diagnosis and a brief statement stating why portable imaging services are necessary.