Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 25 - Hospital Reimbursement Schedule, Billing Instruction and Maintenance Procedures
Section I-2511 - Rehabilitation Services Reimbursement
Current through Register Vol. 50, No. 9, September 20, 2024
A. Inpatient. Reimbursement for inpatient rehabilitation facility services will be limited to the lesser of covered billed charges or the per diem amount.
|
Per Diem Rate Schedule |
|
|
Hospital Based Rehabilitation Facility |
$ 704 |
|
Freestanding Rehabilitation Facility |
$1225 |
B. Outpatient. Rehabilitation services rendered on an outpatient basis by professional providers such as medical doctors, physical therapists, occupational therapists, and speech therapists will be reimbursed based on the customary and reasonable fee schedule for related CPT-4 procedure codes promulgated by the state of Louisiana, Office of Workers' Compensation. Any facility fees associated with delivery of these professional services will be reimbursed at covered charges less a 10 percent discount. The formula for calculating payment is:
(Billed Charges) - (Noncovered Charges) = Covered Charges x 0.90 = Payment Amount
AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1034.2.
