ARM 37.86.3016. OUTPATIENT HOSPITAL SERVICES, PROSPECTIVE PAYMENT METHODOLOGY, IMAGING SERVICES

(1) Imaging services will be reimbursed with the exception of hospitals reimbursed under ARM 37.86.3005(3) as follows: (a) For each imaging service or procedure, the fee will be the APC rate as in ARM 37.86.3020 or Medicare fee if no APC rate exists. The imaging services reimbursed under this subsection are the individual imaging service codes defined in the CPT/HCPCS. (b) For imaging services where no APC rate or Medicare fee has been assigned, a Medicaid fee will be set in accordance with the resource based relative value scale (RBRVS) methodology found at ARM 37.86.212. (c) For imaging services where no APC rate, Medicare fee or Medicaid fee has been assigned, outpatient hospital-specific percent of charges will be paid. Birthing centers will be reimbursed the statewide outpatient cost to charge ratio.