Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 30 - REIMBURSEMENT OF INPATIENT HOSPITAL SERVICES
Section 30-10 - Hospital specific levels of care
Universal Citation: WY Code of Rules 30-10
Current through September 21, 2024
(a) The Department shall reimburse the following levels of care using hospital specific payment rates, unless reimbursed as specialty services:
(i) Major surgery;
(ii) Intensive care unit ("ICU")/Cardiac care
unit ("CCU") services/Burn Care.
(iii) Level of care psychiatric services;
and
(iv) Rehabilitation
services.
(b) Determination of payment rates. The payment rates for hospital specific levels of care shall be:
(i) The hospital's base
period allowable Medicaid per discharge costs, determined pursuant to Section
9;
(ii) The inflation adjustment
established pursuant to Section 20;
(iii) The capital payment determined pursuant
to Section 18; and
(iv) The direct
medical education payment determined pursuant to Section 19.
(c) Caps for hospital specific payment rates.
(i) Payment rates for hospital
specific levels of care shall not exceed one-hundred ten (110) percent of the
median cost per discharge for all participating providers except children's
hospitals.
(ii) Payment rates for
children's hospitals shall not exceed one-hundred fifty (150) percent of the
median cost per discharge for all participating providers.
(iii) For purposes of this subsection,
providers with five or fewer discharges during the period from July 1, 1994,
through December 31, 1996, were not considered.
Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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