Sec. 679.5. Units of service—definitions and restrictions

(a) The unit of service shall be a clinic visit as defined below whether the service is delivered at the main certified site, or at a certified satellite site or, prior to April 1, 2016, off-site.

(b) A clinic visit is or defined as all the approved clinical services provided for a person, his/her collateral or potential admittee on a common date of service by practitioners of the healing arts and/or other authorized parties, except as follows:

(1) If a diagnostic and evaluation service is conducted over more than one day, the date of service for claiming purposes is the last day the service is provided.

(2) If an on-site clinic visit is provided and claimed for reimbursement on the same day as an off-site clinic visit (as allowed prior to April 1, 2016), reimbursement for each visit is considered a separate clinic visit.

(c) A clinic visit must include face-to-face service as defined by allowable Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) and/or Current Dental Terminology (CDT) codes, or such allowable services provided via telehealth.