PRACTITIONER UPPER PAYMENT LIMIT (UPL) ALSO KNOWN AS ENHANCED RATES FOR PRACTITIONER SERVICES DELIVERED BY THE UNIVERSITY OF NEVADA SCHOOL OF MEDICINE (UNSOM)


Practitioner Upper Payment Limit (UPL) also known as Enhanced Rates for Practitioner Services delivered by the University of Nevada School of Medicine (UNSOM)

In order to ensure access to University of Nevada School of Medicine (UNSOM) practitioner services by needy individuals in the State of Nevada, and to recognize the higher cost of providing practitioner services in a teaching environment, UNSOM receives a quarterly supplemental payment for outpatient Fee-For-Service claims in addition to the Medicaid Base Rate(s) normally paid for said services. The formula for calculating these payments is authorized pursuant to the Medicaid State Plan Attachment 4.19 B, Pages 8 and 9.

    Last Edited: 5/24/2017