Section 1143.57. Limitations on payment

The following limits apply to payment for compensable services:

(1) Payment for office visit for podiatric services is limited to the podiatrist’s usual charge to the general public, not to exceed the maximum allowable payment established in Chapter 1150 (relating to MA Program payment policies) and the MA Program fee schedule.

(2) Payment is made to only one podiatrist for a particular service or procedure and services shall be billed in the name of the podiatrist providing the service.

(3) Payment for X-rays taken in the podiatrist’s office during the course of a treatment is limited to the maximum fee per limb specified in the MA Program fee schedule, in addition to the visit fee.

The provisions of this § 1143.57 adopted August 27, 1982, effective August 28, 1982, 12 Pa.B. 2855; amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932; amended September 30, 1988, effective October 1, 1988, 18 Pa.B. 4418. Immediately preceding text appears at serial page (117379).

Notation

Cross References

This section cited in 55 Pa. Code § 1143.51 (relating to general payment policy); and 55 Pa. Code § 1143.52 (relating to payment conditions for various services).