Are routine-care services delivered in conjunction with a clinical trial covered under HCAP?
Per OAC 5101:3-2-03 (A)(2)(g), services of a research nature, services which are experimental and not in accordance with customary standards of medical practice, or services which are not commonly used are not covered. However, a patient may apply for routine-care charges delivered during a clinical trail related to: • Items or services that are typically provided absent a clinical trial (i.e., medically necessary conventional care) • Items and services that are medically necessary for the diagnosis or treatment of complications arising from the provision of an investigational item or service. 7.5 Appendix A of OAC 5101:3-2-02 indicates that dental services billed under UB92 Revenue Code 0512 (Dental Clinic) are covered. Does this mean all dental services, including routine and preventative dental services, performed in a hospital-based dental clinic are covered under HCAP? Generally speaking, no. OAC 5101:3-2-03 (A)(2)(h)(i) states that dental services are only covered in a hospital s
