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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 § 6210.75. Noncompensable services.

§ 6210.75. Noncompensable services.

 Payment will not be made for:

   (1)  Services provided to a recipient who no longer requires the level of care for which payment is authorized by the CAO.

   (2)  Reserved bed days that exceed the limits specified in §  6210.71 (relating to limitations on payment for reserved bed days).

   (3)  Services provided to a recipient occupying a bed which is not certified for the level of care for which payment is authorized by the CAO.

   (4)  Services covered but disallowed by Medicare.

   (5)  Services rendered by a provider that do not meet the conditions for payment established by this chapter and Chapters 1101 and 6211 (relating to general provisions; and allowable cost reimbursement for non-State operated intermediate care facilities for individuals with an intellectual disability).

   (6)  Services directly reimbursable under the MA Program.


   The provisions of this §  6210.75 amended under section 443.1(2) and (3) of the Human Services Code (62 P.S. §  443.1(2) and (3)).


   The provisions of this §  6210.75 amended June 17, 2016, effective June 18, 2016, 46 Pa.B. 3177. Immediately preceding text appears at serial page (276206).

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