- (1) For ESWL treatment to both kidneys during the same treatment period, Medicaid will pay the surgeon one-and-a-half times the regular reimbursement rate for the surgical procedure.
- (2) For repeat ESWL treatments on the same recipient within a ninety-day period,Medicaid will reimburse the surgeon at half the regular reimbursement rate for the surgical procedure.
Author: Charles A. Reasner
Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. §§401, etseq.
History: Rule effective October 13, 1987.