Payment is made at an all-inclusive rate for each visit for covered services. The department follows the standards established by the Medicare, Medicaid, and State Children's Health Insurance Program Benefits Improvement and Protection Act of 2000, Title II, § 702 (114 Stat. 2763A-572), as amended to July 1, 2019, to determine a facility's rate of payment.

In the absence of specific regulations relating to allowable costs, the department bases allowable cost decisions on the Medicare Provider Reimbursement Manual (Centers for Medicare & Medicaid Services Pub. 15-1), as specified in § 67:16:04:62.

Covered services that are not reimbursed as part of the all-inclusive rate will be reimbursed at the applicable medical assistance reimbursement methodology for the service.

Source: 23 SDR 109, effective January 5, 1997; 33 SDR 44, effective September 20, 2006; 40 SDR 122, effective January 7, 2014; 46 SDR 50, effective October 10, 2019.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1(2).

Prior versions effective: 2014-01-07.