Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 7346 (November 25, 2023).

55 Pa. Code § 6100.483. Provider billing.

§ 6100.483. Provider billing.

 (a)  The provider shall submit claims in accordance with §  1101.68 (relating to invoicing for services).

 (b)  The provider shall use the Department’s information system, and forms specified by the Department, to submit claims.

 (c)  The provider shall only submit claims that are substantiated by documentation as specified in §  6100.226 (relating to documentation of claims).

 (d)  The provider may not submit a claim for a service that is inconsistent with this chapter, inappropriate to an individual’s needs or inconsistent with the individual plan.

Cross References

   This section cited in 55 Pa. Code §  6100.805 (relating to vendor goods and services).

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