(1) Reimbursement for family planning services is as follows:

(a) for physicians reimbursement is provided in accordance with the methodologies described in ARM 37.85.212 and 37.86.105;

(b) for mid-level practitioners reimbursement is provided in accordance with the methodologies described in ARM 37.86.205 and 37.86.212;

(c) for local delegate agencies the lowest of the provider's usual and customary charge for this service or the department's fee schedule.

(2) The fees in the department's fee schedule for the local delegate agencies are for each item or procedure the average of the charges for that item or procedure submitted by the delegate agencies during the preceding fiscal year. The adjustments to the fee schedule based upon the annual averaging may not exceed the adjustment for family planning services authorized by the legislature for that fiscal year. The fees in the fee schedule for services provided by physicians or mid-level practitioners may not exceed the fees available for those services set forth in ARM 37.86.105 or 37.86.205 and 37.86.212.

(3) The procedure billing codes and department fee schedules are available from the department's fiscal agent.