Pennsylvania Code
Title 34 - LABOR AND INDUSTRY
Part VIII - Bureau of Workers' Compensation
Chapter 127 - WORKERS' COMPENSATION MEDICAL COST CONTAINMENT
Subchapter B - MEDICAL FEES AND FEE REVIEW
CALCULATIONS
Section 127.117 - Outpatient acute care providers, specialty hospitals and other cost-reimbursed providers not subject to the Medicare fee schedule
Current through Register Vol. 54, No. 38, September 21, 2024
The following services shall be paid on a cost-reimbursed basis for medical treatment rendered under Act 44:
(1) Outpatient services of general acute care providers and specialty hospitals reimbursed by Medicare using the HCFA Form 2552 or any successor form.
(2) Inpatient services provided in specialty hospitals and distinct part rehabilitation and psychiatric units of general acute care hospitals, which are exempt from the DRG reimbursement methodology and are reimbursed by Medicare using the HCFA Form 2552 or any successor form.
(3) Services provided in Comprehensive Outpatient Rehabilitation Facilities reimbursed by Medicare using the HCFA Form 2088 or any successor form.
(4) Services provided in outpatient therapy centers electing cost reimbursement for Medicare using the HCFA Form 2088 or any successor form.
This section cited in 34 Pa. Code § 127.101 (relating to medical fee caps-Medicare); 34 Pa. Code § 127.118 (relating to RCCs-generally); 34 Pa. Code § 127.119 (relating to payments for services using RCCs); 34 Pa. Code § 127.120 (relating to RCCs-comprehensive outpatient rehabilitation facilities (CORFs) and outpatient physical therapy centers); 34 Pa. Code § 127.126 (relating to new providers); 34 Pa. Code § 127.155 (relating to medical fee updates on and after January 1, 1995-outpatient acute care providers, specialty hospitals and other cost-reimbursed providers).
