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).

55 Pa. Code § 1141.51. General payment policy.

PAYMENT FOR PHYSICIANS’ SERVICES


§ 1141.51. General payment policy.

 Payment is made for covered services provided by participating physicians subject to the conditions and limitations established in Chapter 1101 (relating to general provisions), § §  1141.52—1141.57, 1141.59 and Chapter 1150 (relating to MA Program payment policies). Payment will not be made for a covered physicians’ service if payment is available from another public agency or another insurance or health program.

Authority

   The provisions of this §  1141.51 issued under sections 403(a) and (b), 443.2(1) and (2), 443.3(1) and (2)(i)—(v), 443.4 and 509 of the Public Welfare Code (62 P. S. § §  403(a) and (b), 443.2(1) and (2), 443.3(1), 443.3(2)(i)—(v), 443.4 and 509).

Source

   The provisions of this §  1141.51 adopted August 15, 1980, effective September 1, 1980, 10 Pa.B. 3386; amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932; amended September 7, 1984, effective July 1, 1984, 14 Pa.B. 3252; amended September 30, 1988, effective October 1, 1988, 18 Pa.B. 4418. Immediately preceding text appears at serial page (96100).

Cross References

   This section cited in 55 Pa. Code §  1141.52 (relating to payment conditions for various services).



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