Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1151 - INPATIENT PSYCHIATRIC SERVICES
PAYMENT FOR INPATIENT PSYCHIATRIC SERVICES
Section 1151.42 - Payment methods and rates
Current through Register Vol. 54, No. 44, November 2, 2024
(a) The Department will pay inpatient psychiatric facilities a payment rate based on cost items that are determined to be allowable under § 1151.44 (relating to allowable costs).
(b) The Auditor General will audit each inpatient psychiatric facility's cost report to determine allowable costs under State and Federal regulations.
(c) Out-of-State private psychiatric hospitals are reimbursed under § 1151.50 (relating to payment for out-of-State private psychiatric hospital services).
(d) Payment for inpatient hospital services, including acute care general hospitals and their district part units, private psychiatric hospitals and freestanding rehabilitation hospitals, will not be made in excess of the amount which would be paid in the aggregate for those services under Medicare principles of reimbursement in 42 CFR Part 413 (relating to principles of reasonable cost reimbursement; payment for end-stage renal disease services).
The provisions of this §1151.42 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. §§ 201 and 443.1(1)).
