Section 1243.54. Noncompensable services

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Payment will not be made to a laboratory for the following services regardless of where or to whom they are provided:
(1) Procedures not listed in the fee schedule in the MA Program fees schedule.
(2) Travel to a recipient’s place of residence to collect a specimen. The provider will be reimbursed for performing the procedure if it is compensable; however, no extra payment will be made for mileage.
(3) Procedures that the laboratory is not CLIA-certified to perform.

The provisions of this § 1243.54 adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4614; amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932; amended September 30, 1988, effective October 1, 1988, 18 Pa.B. 4418; amended September 5, 2008, effective September 6, 2008, 38 Pa.B. 4898. Immediately preceding text appears at serial page (276180).

Notation

Authority

The provisions of this section are amended under sections 201(2), 403 and 443.3 of the Public Welfare Code (62 P. S. § § 201(2), 403 and 443.3).

                    
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