Claim Form Providers are required to bill their usual and customary charge for services provided. Refer to the General Information section of this handbook for more information on reimbursement. Billing Dates of Service Providers are required to bill for each date of service that care was provided.
Procedure codes are the same for all four dates of service.
The charges for the procedures are identical for each date of service. The quantity of units is the same for all dates of service. The quantity entered for each detail line represents the number of units for each day, multiplied by the number of days of service. Similarly, the charges for each detail line represent the charges for that service multiplied by the number of days of service. Refer to Appendix 3 of this section for an example of series billing.