317:30-5-568. Elective sterilizations
Payment is made to ambulatory surgical centers for elective sterilizations performed in behalf of eligible individuals if all of the following circumstances are met:
(1) The patient must be at least 21 years of age at the time the consent form is signed,
(2) The patient must be mentally competent,
(3) A properly completed federally mandated consent for sterilization form is attached to the claim, and
(4) The form is signed and dated at least 30 days, but not more than 180 days prior to surgery.