Indiana Code
Chapter 15. Payment to Hospitals; General
12-15-15-2.5. Payment for Physician Services in Emergency Department

Sec. 2.5. (a) Payment for physician services provided in the emergency department of a hospital licensed under IC 16-21 must be at a rate of one hundred percent (100%) of rates payable under the Medicaid fee structure.
(b) The payment under subsection (a) must be calculated using the same methodology used for all other physicians participating in the Medicaid program.
(c) For services rendered and documented in an individual's medical record, physicians must be reimbursed for federally required medical screening exams that are necessary to determine the presence of an emergency using the appropriate Current Procedural Terminology (CPT) codes 99281, 99282, or 99283 described in the Current Procedural Terminology Manual published annually by the American Medical Association, without authorization by the enrollee's primary medical provider.
(d) This section does not apply to a person enrolled in a Medicaid risk based managed care program.
As added by P.L.153-1995, SEC.10. Amended by P.L.119-1997, SEC.5; P.L.245-1999, SEC.1; P.L.223-2001, SEC.10; P.L.152-2017, SEC.23.

Structure Indiana Code

Indiana Code

Title 12. Human Services

Article 15. Medicaid

Chapter 15. Payment to Hospitals; General

12-15-15-1. Services at Hospitals Licensed Under Ic 16-21; Rates Established Under Rules

12-15-15-1.1. Reimbursement to Hospitals for Inpatient Hospital Services; Intergovernmental Transfers; Calculating Medicaid Shortfall

12-15-15-1.2. Reimbursement for Children's Hospital Bordering Indiana; Limitations; Expiration

12-15-15-1.3. Reimbursement to Hospitals for Outpatient Hospital Services; Intergovernmental Transfers; Calculating Medicaid Shortfall

12-15-15-1.5. Additional Reimbursements to Certain Hospitals; Appeal of Amount of Distribution

12-15-15-1.6. Alternative Payment Methodology for Payments to Hospitals

12-15-15-2. Rates Adopted for Hospital Licensed Under Ic 16-21; Prospective or Retrospective Application

12-15-15-2.5. Payment for Physician Services in Emergency Department

12-15-15-3. Services Provided at Hospitals Operating Under Ic 16-24-1; Prospective Payment Rate

12-15-15-4. Per Diem Rate for Services Provided in Hospitals Operating Under Ic 16-24-1

12-15-15-4.5. Payment for HIV Test; Limitation

12-15-15-5. Repealed

12-15-15-6. Fees in Addition to Infant Delivery Fees

12-15-15-8. Repealed

12-15-15-9. Attribution of Payable Claim to County; Amount of Payment on Payable Claims; Conditions on Payments; Funds Available for Payments

12-15-15-9.5. Attribution of Payable Claim to County; Funds Available for Payments; Limitation on Payments

12-15-15-9.6. Limitation on Total Amount of Payments

12-15-15-9.8. Repealed

12-15-15-10. Payments to Providers Under Medicaid Disproportionate Share Provider Program

12-15-15-11. Nominal Charge Hospitals

12-15-15-12. Budget Committee Review of Medicaid Reimbursement to Children's Hospitals Bordering Indiana; Provision of Information; Expiration