Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1101 - GENERAL PROVISIONS
FEES AND PAYMENTS
Section 1101.62 - Maximum fees
Universal Citation: 55 PA Code ยง 1101.62
Current through Register Vol. 54, No. 44, November 2, 2024
The Department's maximum fees or rates are the lowest of the upper limits set by Medicare or Medicaid, or the fees or rates listed in the separate provider chapters and fee schedules or the provider's usual and customary charge to the general public. For the purpose of establishing the usual and customary charge to the general public, the provider shall permit the Department access to payment records of non-MA patients without disclosing the identity of the patients.
This section cited in 55 Pa. Code § 1143.51 (relating to general payment policy); and 55 Pa. Code § 1143.58 (relating to noncompensable services and items).
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