A facility may not include the cost of nonroutine services as an allowable cost on the cost report required in § 67:16:04:34. The provider of the nonroutine service must bill the department directly. Nonroutine services include the following types of services:

1. (1) Prescription drugs;
2. (2) Physician services for direct resident care;
3. (3) Laboratory and radiology services;
4. (4) Mental health services;
5. (5) Therapy services when provided by someone other than a facility employee or a licensed therapist who has a contract with the facility to provide the therapy;
6. (6) Prosthetic devices and prosthetic supplies provided for an individual resident which are prescribed by a doctor and cannot be altered for use by other residents; and
7. (7) Any other professional medical service or supply which may be billed directly to Medicare or Medicaid by the provider of the service.

Source: 15 SDR 68, effective November 7, 1988; 16 SDR 26, effective August 13, 1989; transferred from § 67:16:04:06.01, 21 SDR 8, effective July 25, 1994.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.