Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1150 - MA PROGRAM PAYMENT POLICIES


Current through Register Vol. 53, No. 52, December 30, 2023

The provisions of this Chapter 1150 adopted January 7, 1983, effective 1/1/1983, 13 Pa.B. 305, unless otherwise noted.

The provisions of this Chapter 1150 issued under sections 403(a) and (b), 443.2(1) and (2), 443.3(2)(i)-(v), 443.4 and 509 of the Public Welfare Code (62 P.S. §§ 403(a) and (b), 443.2(1) and (2), 443.3(1), 443.3(2)(i)-(v), 443.4 and 509), unless otherwise noted.

This chapter cited in 55 Pa. Code § 52.42 (relating to payment policies); 55 Pa. Code § 1101.61 (relating to reimbursement policies); 55 Pa. Code § 1101.67 (relating to prior authorization); 55 Pa. Code § 1123.1 (relating to policy); 55 Pa. Code § 1123.12 (relating to outpatient services); 55 Pa. Code § 1123.51 (relating to general payment policy); 55 Pa. Code § 1123.54 (relating to orthopedic shoes, molded shoes and shoe inserts); 55 Pa. Code § 1123.62 (relating to method of payment); 55 Pa. Code § 1126.51 (relating to general payment policy); 55 Pa. Code § 1127.1 (relating to policy); 55 Pa. Code § 1127.51 (relating to general payment policy); 55 Pa. Code § 1127.52 (relating to payment criteria); 55 Pa. Code § 1128.51 (relating to general payment policy); 55 Pa. Code § 1129.1 (relating to policy); 55 Pa. Code § 1130.2 (relating to policy); 55 Pa. Code § 1140.1 (relating to purpose); 55 Pa. Code § 1140.51 (relating to general payment policy); 55 Pa. Code § 1141.1 (relating to policy); 55 Pa. Code § 1141.51 (relating to general payment policy); 55 Pa. Code § 1141.59 (relating to noncompensable services); 55 Pa. Code § 1142.1 (relating to policy); 55 Pa. Code § 1142.51 (relating to general payment policy); 55 Pa. Code § 1143.1 (relating to policy); 55 Pa. Code § 1143.51 (relating to general payment policy); 55 Pa. Code § 1143.57 (relating to limitations on payment); 55 Pa. Code § 1143.58 (relating to noncompensable services and items); 55 Pa. Code § 1144.1 (relating to policy); 55 Pa. Code § 1144.51 (relating to general payment policy); 55 Pa. Code § 1144.53 (relating to noncompensable services); 55 Pa. Code § 1145.1 (relating to policy); 55 Pa. Code § 1145.51 (relating to general payment policy); 55 Pa. Code § 1145.54 (relating to noncompensable services); 55 Pa. Code § 1147.1 (relating to policy); 55 Pa. Code § 1147.2 (relating to definitions); 55 Pa. Code § 1147.12 (relating to outpatient services); 55 Pa. Code § 1147.13 (relating to inpatient services); 55 Pa. Code § 1147.51 (relating to general payment policy); 55 Pa. Code § 1149.1 (relating to policy); 55 Pa. Code § 1149.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1149.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1149.23 (relating to scope of benefits for State Blind Pension recipients); 55 Pa. Code § 1149.51 (relating to general payment policy); 55 Pa. Code § 1149.52 (relating to payment conditions for various dental services); 55 Pa. Code § 1149.54 (relating to payment policies for orthodontic services); 55 Pa. Code § 1150.56b (relating to payment policy for observation services-statement of policy); 55 Pa. Code § 1151.41 (relating to general payment policy); 55 Pa. Code § 1153.1 (relating to policy); 55 Pa. Code § 1153.51 (relating to general payment policy); 55 Pa. Code § 1155.1 (relating to policy); 55 Pa. Code § 1155.31 (relating to general payment policy); 55 Pa. Code § 1163.59 (relating to noncompensable services, items and outlier days); 55 Pa. Code § 1163.451 (relating to general payment policy); 55 Pa. Code § 1163.455 (relating to noncompensable services and items); 55 Pa. Code § 1221.1 (relating to policy); 55 Pa. Code § 1221.43 (relating to participation requirements for hospital clinics and emergency rooms for higher reimbursement rate); 55 Pa. Code § 1221.51 (relating to general payment policy); 55 Pa. Code § 1223.1 (relating to policy); 55 Pa. Code § 1223.12 (relating to outpatient services); 55 Pa. Code § 1223.14 (relating to noncovered services); 55 Pa. Code § 1223.51 (relating to general payment policy); 55 Pa. Code § 1223.54 (relating to noncompensable services and items); 55 Pa. Code § 1225.1 (relating to policy); 55 Pa. Code § 1225.51 (relating to general payment policy); 55 Pa. Code § 1230.1 (relating to policy); 55 Pa. Code § 1230.51 (relating to general payment policy); 55 Pa. Code § 1230.52 (relating to payment conditions for various services); 55 Pa. Code § 1241.1 (relating to policy); 55 Pa. Code § 1243.1 (relating to policy); 55 Pa. Code § 1243.51 (relating to general payment policy); 55 Pa. Code § 1245.1 (relating to policy); 55 Pa. Code § 1245.2 (relating to definitions); 55 Pa. Code § 1245.21 (relating to scope of benefits for the categorically needy); 55 Pa. Code § 1245.22 (relating to scope of benefits for the medically needy); 55 Pa. Code § 1245.23 (relating to scope of benefits for State Blind Pension recipients); 55 Pa. Code § 1245.51 (relating to general payment policy); 55 Pa. Code § 1247.1 (relating to policy); 55 Pa. Code § 1249.1 (relating to policy); 55 Pa. Code § 1249.51 (relating to general payment policy); 55 Pa. Code § 1251.21 (relating to scope of benefits for the categorically needy); and 55 Pa. Code § 4300.115 (relating to Department established fees).

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