Section 511.12 - Laboratory services - utilization threshold.

511.12 Laboratory services - utilization threshold. This section describes the utilization threshold that the department has established for laboratory services. The department will pay for up to 18 laboratory service procedures in a benefit year. For purposes of this subdivision, a procedure consists of all services which are claimed for a single date of service and which are represented by a single laboratory procedure code, as listed and defined in the Medicaid Management Information System laboratory fee schedule (July 1990; a new laboratory fee schedule becomes effective on July 1, 1991). These fee schedules are available from the department and may also be found in the Medicaid Management Information System Provider Manual for laboratories. Copies of the fee schedules are available from the Department of Social Services, Division of Medical Assistance, 99 Washington Avenue, Albany, NY 12210. These manuals are provided free of charge to every MA laboratory provider.

 

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