67:16:43:09Claim requirements.

Section · Administrative Rules of South Dakota · View on sdlegislature.gov ↗

Rulemaking activity

Article 67:15 (LIEAP), Article 67:16 (MS - Transportation) Article 67:18 (Child Support Enforcement), Article 67:42 (Family Foster Homes), Article 67:46 (Economic Assistance)Effective

A claim for services provided under this chapter must be submitted on a form that contains the following information: (1) The child's full name; (2) The child's medical assistance identification number from the child's medical identification card; (3) Third-party liability information required under chapter 67:16:26; (4) Date of service; (5) The provider's current daily rate. The provider may not subtract other third-party or cost-sharing from this charge; (6) Units of service furnished, if more than one; (7) The applicable diagnosis codes; (8) The provider's name and National Provider Identification number; (9) Type of admission; (10) The prior authorization number assigned by the care manager; (11) The revenue code; and (12) The type of bill.

Source: 23 SDR 2, effective July 15, 1996; 42 SDR 51, effective October 13, 2015; 52 SDR 126, effective July 1, 2026.

General Authority

SDCL 28-6-1 ↗
Amended by HB1239 (2020) — require the costs of nursing homes to be rebased every five years for purposes o
Amended by HB1229 (2019) — require optional services through Medicaid to be authorized through special appr
Amended by SB30 (2019) — remove certain unnecessary federal references and dates from certain provisions

Law Implemented

SDCL 28-6-1 ↗
Amended by HB1239 (2020) — require the costs of nursing homes to be rebased every five years for purposes o
Amended by HB1229 (2019) — require optional services through Medicaid to be authorized through special appr
Amended by SB30 (2019) — remove certain unnecessary federal references and dates from certain provisions

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