§ 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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