§ 1150.55. Obstetrical services.
(a) The fee for a delivery includes:
(1) Antepartum care provided on an inpatient basis.
(2) Inpatient and outpatient office or home visits provided by the practitioner who performed the delivery, for a purpose related to delivery, during the number of postpartum days specified in the Medical Assistance Program Fee Schedule for each obstetrical procedure. During this specified period, the practitioner who performed the delivery is eligible to receive payment for treatment of a medical or surgical condition if the diagnosis necessitating the treatment is different and unrelated to the delivery.
(b) The practitioner performing the delivery may also bill for visits for care of the newborn if that practitioner is the responsible attending physician for the newborn.
(c) In addition to the practitioner performing the delivery, another practitioner may bill for stand-by services but only in the case of Cesarean sections or high risk deliveries. This is in lieu of billing for an initial visit.
Source The provisions of this § 1150.55 adopted January 7, 1983, effective January 1, 1983, 13 Pa.B. 305; amended September 30, 1988, effective November 1, 1988, 18 Pa.B. 4418. Immediately preceding text appears at serial page (96131).
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