CMS-179 4.19 (k)(1)

Medicaid State Plan Base Plan Pages (CMS-179)

Exhibit AG 508 (2021 version 1)

State Plan Under Title XIX of the Social Security Act (Base plan pages)

OMB: 0938-0193

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Form Approved CMS-179
OMB No. 0938-0193
66a
Revision:

HCFA-AT-81-34
10-81

(BPP)

State:
Citation
4.19 (k)(1)
42 CFR 405.515

Payments to Physicians for

1903(i)(7) of the Act

Clinical Laboratory Services
For services performed by an outside laboratory for a
physician who bills for the service, payment does not exceed
the amount that would be authorized under Medicare in
accordance with 42 CFR 405.515(b),(c) and (d).

Yes
Not applicable. The Medicaid agency does not allow
payment under the plan to physicians for outside
laboratory services.

______________________________________________________________________________
TN No.
Supersedes
Approval Date
Effective Date
TN No.
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File Typeapplication/pdf
File Title66a
AuthorCMS
File Modified2021-03-05
File Created2018-09-21

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