HI 00610.490 Noninpatient Psychiatric Services Limitation Computation
To compute the benefit:
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A.
Consider all noninpatient psychiatric reasonable charges up to a maximum of $500,
whether or not applied to the deductible.
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C.
Subtract any unsatisfied deductible.
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Example
In 1982, a patient had psychiatric treatment while not an inpatient and incurred total
reasonable charges of $600. The benefit payable is computed as follows: $500 (maximum
charges allowable) ×.625=$312.50. Since no part of the deductible has been satisfied
for the year, subtract $75, leaving $237.50. The benefit payable is $190 (80 percent
of $237.50).