HI 00610.490 Noninpatient Psychiatric Services Limitation Computation
To compute the benefit:
Consider all noninpatient psychiatric reasonable charges up to a maximum of $500, whether or not applied to the deductible.
Multiply by .625.
Subtract any unsatisfied deductible.
Multiply by 8.
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).