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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 6142 (September 30, 2023).

55 Pa. Code § 1151.42. Payment methods and rates.

§ 1151.42. Payment methods and rates.

 (a)  The Department will pay inpatient psychiatric facilities a payment rate based on cost items that are determined to be allowable under §  1151.44 (relating to allowable costs).

 (b)  The Auditor General will audit each inpatient psychiatric facility’s cost report to determine allowable costs under State and Federal regulations.

 (c)  Out-of-State private psychiatric hospitals are reimbursed under §  1151.50 (relating to payment for out-of-State private psychiatric hospital services).

 (d)  Payment for inpatient hospital services, including acute care general hospitals and their district part units, private psychiatric hospitals and freestanding rehabilitation hospitals, will not be made in excess of the amount which would be paid in the aggregate for those services under Medicare principles of reimbursement in 42 CFR Part 413 (relating to principles of reasonable cost reimbursement; payment for end-stage renal disease services).


   The provisions of this §  1151.42 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. § §  201 and 443.1(1)).


   The provisions of this §  1151.42 adopted September 30, 1983, effective July 1, 1983, 13 Pa.B. 2976; amended June 18, 1993, effective July 1, 1993, 23 Pa.B. 2917; amended October 29, 1993, effective July 1, 1993, 23 Pa.B. 5241. Immediately preceding text appears at serial page (181778).

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