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Title 802 | Chapter 003 | Regulation 020


802 KAR 3:020.Payment schedule for sexual assault examinations.

Section 1.

Sexual Assault Examination Program.

(1)

Reimbursement for performing a sexual assault forensic-medical examination pursuant to 502 KAR 12:010 shall be for the actual amount billed and shall not exceed:

(a)

$200 for a physician, sexual assault nurse examiner, or other qualified medical professional performing the examination;

(b)

$250 for an examination facility for use of an emergency or examination room;

(c)

$100 for an examination facility or laboratory that performed diagnostic laboratory testing; and

(d)

$100 for an examination facility where administered medications and pharmaceuticals were prescribed as a result of the examination and as part of basic treatment.

(2)

Reimbursement for additional services related to a sexual assault forensic-medical examination requiring HIV post-exposure prophylaxis shall be for the actual amount billed and shall not exceed the following limitations:

(a)

$150 for three (3) follow-up examinations, not to exceed a total of fifty (50) dollars per examination;

(b)

Laboratory testing:

1.

$150 for initial testing conducted during the sexual assault examination in the examination facility; and

2.

$215 for follow-up testing conducted during the three (3) follow-up examinations, not to exceed:

a.

Fifty (50) dollars for testing conducted during day five (5) to day seven (7) of prophylactic treatment;

b.

Ninety (90) dollars for testing conducted after day twelve (12) of prophylactic treatment; and

c.

Seventy-five (75) dollars for testing conducted near or at the end of prophylactic treatment; and

(c)

Medications:

1.

$800 for a twenty-eight (28) day supply of HIV prophylaxis medication, not to exceed:

a.

$200 for the first seven (7) day supply; and

b.

$600 for the remaining twenty-one (21) day supply; and

2.

Thirty (30) dollars for a twenty-eight (28) day supply of anti-nausea medication.

HISTORY: (44 Ky.R. 2167; 2329; eff. 6-1-2018.)

7-Year Expiration: 6/1/2025

Last Action: 12/15/2021


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