Iowa Payment Resources
Summary of payment program
Iowa Code section 709.22(1)(c)(8) states: The patient has the right to a sexual assault examination performed at state expense.
The Sexual Abuse Examination (SAE) program has the following billing guidelines by law and administrative rule.
- The program is the primary payer for sexual abuse medical and evidentiary exams.
- A provider is prohibited from billing the victim for the forensic and medical examination, including any balance remaining after the SAE program has paid.
- A provider is prohibited from billing the victim’s cost of the exam to the private or public health insurance provider.
- Bills for an SAE examination are submitted to the program directly by the examiner, facility, or laboratory.
- The bill must itemize each cost and include the name of each service provided.
- The diagnosis must be properly coded for sexual abuse, generally T74.21XA, T74.22XA, and state that the services were a sexual abuse examination.
- The bill must include the Federal identification Number of the provider, the date of service, and the victim’s name and date of birth.
- Medical records must be attached.
Funding for the SAE and Crime Victim Compensation programs comes entirely from state and federal criminal fines and penalties. No tax dollars are used.
Submit bills to:
Crime Victim Assistance Division
Lucas State Office Building
321 East 12th Street
Des Moines, Iowa 50319
515-281-5044 or 1-800-373-5044
The cost of a medical examination for the purpose of gathering evidence and the cost of treatment for the purpose of preventing venereal disease shall be paid from the fund established in section 915.94.
The Sexual Assault Examination Payment Program (SAE Program) has a three-fold purpose. The state pays the cost of forensic examinations to ensure that evidence is collected in a proper and timely manner. The state pays the cost of the medical examination to assure the well-being of victims of sexual abuse. Finally, the state pays the cost of treatment for the prevention of a sexually transmitted infection (STI) for a victim.
The SAE program pays the cost of an evidentiary sexual abuse examination whether or not the victim reports the crime to law enforcement. A timely exam ensures that prosecutors have effectively collected evidence if the victim later decides to report the crime. Sexual Abuse evidence is most effectively collected from adults in the 72 hours immediately following the assault. For children, the effective collection period is slightly longer, but best done as soon as possible.
Payment for sexual abuse examinations include:
1. The physician or SANE primary examiner fee up to $200
- History and documentation;
- Physical examination;
- Collection of specimens;
- Follow up tests and treatment for the prevention of STIs.
2. Facility fees up to $300 (emergency department, clinic, or office)
- The examination room;
- Nursing services;
- Medical supplies;
- Medical equipment use such as colposcope and camera.
3. Reasonable Laboratory fees paid at 75%
- Collection of laboratory specimens;
- STI testing, including HIV and hepatitis screening;
- Pregnancy testing;
- Drug and alcohol screens;
- Date rape drug screens.
4. Reasonable Pharmacy fees paid at 75%
- Prescriptions for the treatment to prevent STI.
- Oral contraceptives and Plan B (morning after pill).
5. Return visit fees
- Testing and treatment for the prevention of STIs;
- Examiner and facility fees have the same payment limits as for the initial examination.
Iowa Crime Victim Compensation Online Application
Coordination with healthcare
Iowa Sexual Abuse Hotline at 800.284.7821 (for support and/or to find an agency)
Notification of Rights and a list of Sexual Assault Programs in Iowa (English & Spanish)