| (a) Subject to the specifications, conditions, limitations,
and requirements established by the Health and Human Services Commission
(HHSC), payment for covered birthing center services provided by a
participating birthing center is limited to the lesser of the provider's
customary charge or the maximum allowable fee listed on a fee schedule
established by HHSC.
(b) The birthing center must bill for the covered services
that it provides. The attending physician, certified nurse midwife
(CNM), or licensed midwife (LM) will be reimbursed separately. Unless
approved by HHSC, the birthing center may not bill for services provided
by another type of provider. The birthing center must be enrolled
and approved for participation in the Medicaid program at the time
the services are provided.
(c) Reimbursement for services provided by a physician
is described in §355.8085 of this subchapter (relating to Reimbursement
Methodology for Physicians and Other Practitioners). Reimbursement
for services provided by a CNM or an LM is described in §355.8161
of this subchapter (relating to Reimbursement Methodology for Midwife
Services).
|
