Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1187 - NURSING FACILITY SERVICES
Subchapter H - PAYMENT CONDITIONS, LIMITATIONS AND ADJUSTMENTS
Section 1187.109 - Medicare upper limit on payment
Universal Citation: 55 PA Code ยง 1187.109
Current through Register Vol. 54, No. 12, March 23, 2024
Nursing facilities shall submit Medicare information on the MA-11. MA payments will not exceed in the aggregate the comparable amount that Medicare would have paid had the Medicare Program reimbursed for the services rendered.
This section cited in 55 Pa. Code § 1187.108 (relating to gross adjustments to nursing facility payments).
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