Sec. 7 AAC 145.200 - Physician services payment rates

ยง 7 AAC 145.200. Physician services payment rates

(a) Except as otherwise provided in this section, the department will pay an in-state physician in accordance with 7 AAC 145.020, not to exceed 100 percent of the amount determined under 7 AAC 145.050.

(b) The department will pay an out-of-state physician in accordance with 7 AAC 145.025.

(c) The department will not pay separately for office medical supplies and services associated with office visits and procedures because they are included in the practice expense component of the RBRVS methodology used in 7 AAC 145.050. The department will pay for nonroutine office medical and surgical supplies in accordance with 7 AAC 145.050(h).

(d) The department will pay for laboratory or pathology services provided by a physician for which a Medicare payment rate has been established in 42 C.F.R. 405.515, adopted by reference in 7 AAC 160.900, in accordance with the methodology used to determine payment for laboratory services in 7 AAC 145.460.

(e) Repealed 7/1/2019.

(f) The department will pay, in accordance with 7 AAC 145.020, a supervising physician, or will pay, in accordance with 7 AAC 155.010, a tribal health program, for the services of an in-state physician assistant, except that

(1) the department will pay 85 percent of the rate identified in the fee schedule established under 7 AAC 145.050;

(2) laboratory charges will be paid in accordance with 7 AAC 145.460; and

(3) drugs will be paid in accordance with 7 AAC 145.410(g).

(g) The department will pay an out-of-state supervising physician for the services of an out-of-state physician assistant in accordance with 7 AAC 145.025.

(Eff. 2/1/2010, Register 193; am 1/1/2011, Register 196 ; am 7/1/2019, Register 232, January 2019)

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040

AS 47.07.070

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