Veterinarian’s Agreement to Participate and Fee Schedule

Agr 2803.01 Veterinarian’s Agreement to Participate and Fee Schedule. (a) The “Veterinarian’s Agreement and Fee Schedule” form, 11/2024 edition, shall be filed annually with the administrator by a practicing veterinarian in order to participate in the animal population control program. The practicing veterinarian or veterinarian practice may file the “Veterinarian’s Agreement and Fee Schedule” by December 31 of the year prior to the agreement taking effect. (b) The completed agreement shall be sent to: Administrator, Animal Population Control Program, New Hampshire Department of Agriculture, Markets, and Food, 1 Granite Place South, Suite 211, Concord, NH 03301. (c) The practicing veterinarian shall provide the following on the “Veterinarian’s Agreement and Fee Schedule” form to participate: (1) A veterinarian or veterinary practice name; (2) Address; (3) Business telephone number; (4) Business fax number; (5) Name and title of facility representative; (6) Vendor identification number as assigned pursuant to Adm 603; (7) Names of the veterinarians practicing at the facility and their signatures; and (8) New Hampshire license number for each veterinarian practicing at the facility. (d) The practicing veterinarian shall provide on the application a fee schedule for the following: (1) For sterilization of female dogs, the fee for each of the following categories of weights: a. Up to 25 lbs.; b. 26-50 lbs.; c. 51-75 lbs.; and d. Over 75 lbs.; (2) The fee for sterilization of female cats at any weight; (3) For sterilization of male dogs, the fee for each of the following categories of weights: a. Up to 25 lbs.; b. 26-50 lbs.; c. 51-75 lbs.; and d. Over 75 lbs.; (4) The fee for sterilization of male cats at any weight; (5) The examination fee; and (6) The period for which the foregoing fees shall be effective. (e) The practicing veterinarian shall attest to the following on the “Veterinarian’s Agreement and Fee Schedule” form: “I certify that the fee schedule is accurate as outlined above and will remain in effect from this date to the above expiration date. The fees will be for the entire surgical procedure, which shall mean: sterilization, maintenance, discharge and removal of sutures. I understand that I will be reimbursed 100% of the above fees less the co-payment made by the owner under the program. I understand that I will be reimbursed for pre-surgical immunization fees up to $25 pursuant to RSA 437-A:4, II (b). I understand that I will also be reimbursed for a routine physical examination fee prior to sterilization under the program. I also understand that any fees associated with any surgical complications are not subject to reimbursement from the NH Department of Agriculture, Markets and Food, Animal Population Control Program. I understand that if the administrator of the Animal Population Control Program determines any of the above fees unreasonable pursuant to RSA 437-A:4, I. I will not be eligible to participate. I further understand that if funds become depleted, I will be notified in advance to stop accepting clients under this program. I agree to submit complete and correct monthly invoices and supporting Application(s) for Sterilizing a Dog or Cat within 10 days of the end of the month in which the sterilization surgery and immunization were performed. I understand that I will not be reimbursed for surgeries on ineligible pets, including services performed when the program was closed. I certify that I have read and understand all statements above and am in compliance with all applicable NH Statutes and NH Department of Agriculture, Markets, and Food rules, including but not limiting to RSA 437-A and Agr 2800.” Source. #5840, eff 6-17-94; ss by #6786, eff 7-1-98; ss by #7453, eff 2-22-01, EXPIRED: 2-22-09 New. #10568, eff 4-18-14; ss by #14129, eff 11-26-24, EXPIRES: 11-26-34