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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 2336 (April 27, 2024).

55 Pa. Code § 1101.62. Maximum fees.

§ 1101.62. Maximum fees.

 The Department’s maximum fees or rates are the lowest of the upper limits set by Medicare or Medicaid, or the fees or rates listed in the separate provider chapters and fee schedules or the provider’s usual and customary charge to the general public. For the purpose of establishing the usual and customary charge to the general public, the provider shall permit the Department access to payment records of non-MA patients without disclosing the identity of the patients.


   The provisions of this §  1101.62 amended November 18, 1983, effective November 19, 1983, 13 Pa.B. 3653. Immediately preceding text appears at serial page (75057).

Cross References

   This section cited in 55 Pa. Code §  1143.51 (relating to general payment policy); and 55 Pa. Code §  1143.58 (relating to noncompensable services and items).

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