Can MMTPs bill separately for the annual physicals provided to methadone patients? Are these services included in the weekly Medicaid rate or can MMTPs bill separately for this service?
The initial and annual physicals required under the OASAS Part 828 regulations are included as part of the weekly rate and should not be billed separately. However, if lab and/or diagnostic tests are ordered as a part of the physicals, those may be billed to MA FFS, by the lab service. Under Medicaid if the client is enrolled in a Medicaid Managed Care plan, the managed care plan’s approval and billing procedures apply.
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