Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 8238 (December 30, 2023).

31 Pa. Code § 69.42. Payments under the act.

§ 69.42. Payments under the act.

 

   An insurer shall make payments to providers in accordance with the Medicare Program as applied in this Commonwealth by the carrier and intermediaries. Care covered under the Medicare Program shall be reimbursed at 110% of the Medicare payment or a different allowance as may be determined under §  69.12(b) (relating to exemption from payment limitations). Medicare co-insurance and deductibles may not be excluded in payments made by the insurer.



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