N.Y. Financial Services Law § 602

§ 602. Applicability. (a) This article shall not apply to health care\nservices, including emergency services, where physician fees are subject\nto schedules or other monetary limitations under any other law,\nincluding the workers' compensation law and article fifty-one of the\ninsurance law, and shall not preempt any such law.\n (b)(1) With regard to emergency services billed under American medical\nassociation current procedural terminology (CPT) codes 99281 through\n99285, 99288, 99291 through 99292, 99217 through 99220, 99224 through\n99226, and 99234 through 99236, the dispute resolution process\nestablished in this article shall not apply when:\n (A) the amount billed for any such CPT code meets the requirements set\nforth in paragraph three of this subsection, after any applicable\nco-insurance, co-payment and deductible; and\n (B) the amount billed for any such CPT code does not exceed one\nhundred twenty percent of the usual and customary cost for such CPT\ncode.\n (2) The health care plan shall ensure that an insured shall not incur\nany greater out-of-pocket costs for emergency services billed under a\nCPT code as set forth in this subsection than the insured would have\nincurred if such emergency services were provided by a participating\nphysician.\n (3) Beginning January first, two thousand fifteen and each January\nfirst thereafter, the superintendent shall publish on a website\nmaintained by the department of financial services, and provide in\nwriting to each health care plan, a dollar amount for which bills for\nthe procedure codes identified in this subsection shall be exempt from\nthe dispute resolution process established in this article. Such amount\nshall equal the amount from the prior year, beginning with six hundred\ndollars in two thousand fourteen, adjusted by the average of the annual\naverage inflation rates for the medical care commodities and medical\ncare services components of the consumer price index. In no event shall\nan amount exceeding one thousand two hundred dollars for a specific CPT\ncode billed be exempt from the dispute resolution process established in\nthis article.\n