Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part V - Hospital Services
Subpart 1 - Inpatient Hospital Services
Chapter 24 - Out-of-State Hospitals
Section V-2403 - Reimbursement Methodology
Universal Citation: LA Admin Code V-2403
Current through Register Vol. 50, No. 9, September 20, 2024
A. Effective for dates of service on or after September 20, 2023, payment for all out-of-state inpatient services, other than organ transplants, shall be made at the Louisiana in-state prospective peer group rate in effect for the corresponding type of non-teaching hospital or specialty carve out service.
1. Separate prospective per diem rates will
be paid for out-of-state inpatient services provided in acute care general
hospitals, psychiatric hospitals and services, rehabilitation hospitals, long
term acute care hospitals, children's hospitals, nursery services, neonatal
intensive care services, pediatric intensive care services, and burn unit
intensive care services.
B. Effective for dates of service on or after September 20, 2023, payment for inpatient organ transplant service provided by out-of-state hospitals shall be paid as follows:
1. 40 percent of allowable covered billed
charges for beneficiaries ages 21 and above; or
2. 60 percent of allowable covered billed
charges for beneficiaries under age 21.
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
