Pennsylvania Code
Title 31 - INSURANCE
Part II - Automobile Insurance
Chapter 69 - MOTOR VEHICLE FINANCIAL RESPONSIBILITY LAW
Subchapter A - AUTOMOBILE INSURANCE MEDICAL COST CONTAINMENT
PROVIDER BILLING
Section 69.21 - Allowable payment amounts

The provider may not require payment in excess of the Medicare payment pertaining to the applicable specialty under Medicare for comparable services at the time services were rendered, or the provider's usual and customary charge, whichever is less. An insurer shall use the Medicare payment applicable in this Commonwealth to determine the appropriate payment. The applicable Medicare payment shall be utilized even when a service is not a reimbursed service under Medicare. If no Medicare payment has been calculated, payment shall be 80% of the provider's usual and customary charge.