Outpatient Hospital Services Sample Clauses

Outpatient Hospital Services. Use of the Hospital's facilities and equipment for surgery, respiratory therapy, chemotherapy, radiation therapy and dialysis therapy. Inborn Errors of Metabolism‌ Treatment under the supervision of a Physician of inborn errors of metabolism that involve amino acid, carbohydrate and fat metabolism and for which medically standard methods of diagnosis, treatment and monitoring exist. Benefits include expenses of diagnosing, monitoring, and controlling the disorders by nutritional and medical assessment, including but not limited to clinical services, biochemical analysis, medical supplies, prescription drugs, corrective lenses for conditions related to the inborn error of metabolism, nutritional management, and Medical Foods used in treatment to compensate for the metabolic abnormality and to maintain adequate nutritional status. Infertility - Diagnosis and Treatment‌ The Plan will pay for: The diagnosis and treatment of infertility, including:

Outpatient Hospital Services. Outpatient Hospital services are Medically Necessary mental health care services provided in a hospital setting. The outpatient care and treatment services that an Enrollee receives must be under the direction of a licensed physician with the appropriate specialty..

Outpatient Hospital Services. 152 6.1.39 Personal Care Assistance (PCA) Services. 152 6.1.40 Physician Services. 152

Outpatient Hospital Services. Outpatient hospital services are medically necessary behavioral health services provided in a hospital setting. The outpatient care and treatment services that an enrollee receives must be under the direction of a licensed physician with the appropriate specialty.

Outpatient Hospital Services. Provided by acute care hospitals (licensed under RCW 70.41).

Outpatient Hospital Services. In the absence of a contract, the default payment rate for outpatient hospital services billed on a UB-04 will be based on the AHCCCS outpatient hospital fee schedule pursuant to A.R.S.

Outpatient Hospital Services. MANDATORY Outpatient hospital services are medically necessary mental health care services provided in a hospital setting. The outpatient care and treatment services that an individual receives must be under the direction of a licensed physician. Outpatient hospital services are paid at a line item rate for covered outpatient revenue center codes. Specifically, the provider is at risk for outpatient revenue center codes: • REV 450 - Emergency room • REV 513 - Psychiatric clinic • REV 901 - Psychiatric electroshock treatment • REV 914 - Psychiatric visit/individual therapy • REV 918 - Psychiatric/Testing The provider is NOT at risk for outpatient medical supplies such as dressings, splints, oxygen, drugs and services such as x-rays and laboratory. These outpatient medical supplies and services are covered under the Medicaid fee-for-service system. The provider is at risk for outpatient emergency hospital services related to a mental health condition that falls within the definition of emergency mental health services. Emergency mental health services are those services required to meet the needs of an individual who is experiencing an acute crisis which is at a level of severity that would meet the requirements for involuntary examination pursuant to Section 394.463, Florida Statutes, and who, in the absence of a suitable alternative or mental health medication, would require hospitalization. Outpatient hospital service Medicaid policy requirements are as follows: 1. The provider provides outpatient hospital and emergency mental health services as medically necessary and appropriate, and without any specified dollar limitation. 2. The provider designates a facility to provide emergency mental health and evaluation services to all enrollees on a 24 hours a day, 7 days per week basis. 3. The provider covers the cost of emergency mental health and evaluation services provided to all enrollees at any non-designated facility when medically necessary and appropriate until such time as they can be safely transported to a plan facility. 4. The provider does not require prior authorization of emergency mental health services by any enrollee but may require post authorization to expedite plan payment. Performance measures for this section include: • Utilization rates and access times for emergency room mental health care/evaluation services during evenings and weekends. • Payment of claims for emergency room mental health care or evaluation services.

Outpatient Hospital Services. AVAHS shall reimburse ATHP for outpatient hospital services at the all inclusive rate approved each year by the IHS Director under the title “Outpatient Per Visit Rate (Excluding Medicare).”

Outpatient Hospital Services. Diagnostic, therapeutic, and rehabilitative services that are provided to Enrollees in an organized medical facility, for less than a twenty-four

Outpatient Hospital Services. Physical Therapy;