(1) The department reimburses for E&M services provided in the hospital emergency department to clients who arrive for immediate medical attention.
(2) The department reimburses emergency physician services only when provided by physicians assigned to the hospital emergency department or the physicians on call to cover the hospital emergency department.
(3) The department pays a provider who is called back to the emergency room at a different time on the same day to attend a return visit [to] the same client. When this results in multiple claims on the same day, the time of each encounter must be clearly indicated on the claim.
(4) The department does not pay emergency room physicians for hospital admission charges or additional service charges.
