Ala. Admin. Code r. 560-X-16-.08

Current through Register Vol. 42, No. 11, August 30, 2024

Section 560-X-16-.08 - Injections

(1) Injectable drugs administered by physicians and outpatient hospitals are allowable.

(2) Claims for injectable medication administered by the physician should be made on the physician's claim form and submitted to the fiscal agent for payment.

(3) Claims for injectable medications administered in an outpatient hospital should be made on the UB-8 92 and submitted to the fiscal agent by the outpatient facility.

(4) For information concerning injectable medications administered in renal dialysis facilities, please refer to Rule 560-X-24-.05.

(5) The Medicaid Pharmacy Program will review and have final approval of injectable medications and the rate of reimbursement that is billed to the fiscal agent by the physician or outpatient hospital.

Authors: Sam T. Hardin, Janet B. Young, Larry A. Tatum

Ala. Admin. Code r. 560-X-16-.08

Rule effective October 1, 1982. Amended: Effective May 9, 1984; November 10, 1987; April 14, 1992. Amended: Filed January 6, 1998; effective February 10, 1998.

Statutory Authority: State Plan, Attachments 3.1A, 4.18B; Title XIX, Social Security Act; 42 C.F.R. §§401, et seq., 447.331; Omnibus Budget Reconciliation Act of 1990 (Public Law 101-508).

The amended version of this section by Alabama Administrative Monthly Volume XLII, Issue No. 08, May 31, 2024, filed May 20, 2024 is not yet available.