Individual Consideration

Services designated "I.C." in the list of service codes and descriptions in Subchapter 6 of the Speech and Hearing Center Manual are given individual consideration to determine the amount of payment. The amount of payment is determined by using the following criteria: (A) the time required to perform the procedure; (B) the degree of skill required to perform the procedure; (C) the severity or complexity of the member's hearing disorder or disability; (D) the policies, procedures, and practices of other third-party purchasers of health care; and (E) the reasonable and customary practices of speech and hearing centers.