265.932           Amendment to the Definition of “Covered Service” for Third Party Insurance Payment:

265.932           Amendment to the Definition of “Covered Service” for Third Party Insurance Payment:

MSSNY has adopted as policy the following definition of covered service for insurance payment purposes.  A covered service is defined as:  (l) separately identifiable by the American Medical Association Current Procedural Terminology code; (2) allowed, reimbursable, and paid by the third party insurer or plan; and (3) therefore, all other services be considered non-covered and be considered the responsibility of the plan subscriber.

MSSNY will seek legislation incorporating this definition in future legislative actions.(HOD 2002-261; Reaffirmed HOD 2003-268 & 278; Reaffirmed HOD 2013; Reaffirmed HOD 2023)