Section 1230.53. Limitation on payment

(a) For all portable X-ray services, the provider’s maximum payment is the lowest of:

(1) The provider’s usual and customary charge to the general public.

(2) The upper limits set by Medicare or Medicaid.

(3) The maximum fees or rates established in the MA Program fee schedule.

(b) Payment for transportation of portable X-ray or electrocardiogram equipment or both and personnel is limited to one payment per trip to each place of service, regardless of the number of services performed for different recipients at that place of service. If an X-ray and electrocardiogram are performed at one place of service, payment will only be made for transporting the X-ray equipment.

(c) Payment for portable X-ray services limited to those services listed in the MA Program fee schedule.

The provisions of this § 1230.53 adopted August 13, 1982, effective August 14, 1982, 12 Pa.B. 2688; 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 pages (117498) to (117499).

Notation

Cross References

This section cited in 55 Pa. Code § 1230.52 (relating to payment conditions for various services).