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Chapter 182-550 WAC

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HOSPITAL SERVICES

WAC Sections

HTMLPDF182-550-1000Applicability.
HTMLPDF182-550-1050Hospital services definitions.
HTMLPDF182-550-1100Hospital careGeneral.
HTMLPDF182-550-1200Restrictions on hospital coverage.
HTMLPDF182-550-1300Revenue code categories and subcategories.
HTMLPDF182-550-1350Revenue code categories and subcategoriesCPT and HCPCS reporting requirements for outpatient hospitals.
HTMLPDF182-550-1400Covered and noncovered revenue codes categories and subcategories for inpatient hospital services.
HTMLPDF182-550-1500Covered and noncovered revenue code categories and subcategories for outpatient hospital services.
HTMLPDF182-550-1600Specific items/services not covered.
HTMLPDF182-550-1650Adverse events, hospital-acquired conditions, and present on admission indicators.
HTMLPDF182-550-1700Authorization and utilization review (UR) of inpatient and outpatient hospital services.
HTMLPDF182-550-1800Hospital specialty services not requiring prior authorization.
HTMLPDF182-550-1900Transplant coverage.
HTMLPDF182-550-2100RequirementsTransplant hospitals.
HTMLPDF182-550-2200Transplant requirementsCOE.
HTMLPDF182-550-2301Hospital and medical criteria requirements for bariatric surgery.
HTMLPDF182-550-2400Inpatient chronic pain management services.
HTMLPDF182-550-2431Hospice servicesInpatient payments.
HTMLPDF182-550-2500Inpatient hospice services.
HTMLPDF182-550-2501Acute physical medicine and rehabilitation (acute PM&R) programGeneral.
HTMLPDF182-550-2521Client eligibility requirements for acute PM&R services.
HTMLPDF182-550-2531Requirements for becoming an acute PM&R provider.
HTMLPDF182-550-2541Quality of careAgency-approved acute PM&R hospital.
HTMLPDF182-550-2551When the medicaid agency authorizes acute PM&R services.
HTMLPDF182-550-2561The agency's prior authorization requirements for acute PM&R services.
HTMLPDF182-550-2565The long-term acute care (LTAC) programGeneral.
HTMLPDF182-550-2575Client eligibility requirements for LTAC services.
HTMLPDF182-550-2580Requirements for becoming an LTAC hospital.
HTMLPDF182-550-2585LTAC hospitalsQuality of care.
HTMLPDF182-550-2590Agency prior authorization requirements for Level 1 and Level 2 LTAC services.
HTMLPDF182-550-2595Identification of and payment methodology for services and equipment included in the LTAC fixed per diem rate.
HTMLPDF182-550-2596Services and equipment covered by the agency but not included in the LTAC fixed per diem rate.
HTMLPDF182-550-2598Critical access hospitals (CAHs).
HTMLPDF182-550-2600Inpatient psychiatric services.
HTMLPDF182-550-2650Base community psychiatric hospitalization payment method for medicaid and CHIP clients and nonmedicaid and non-CHIP clients.
HTMLPDF182-550-2750Hospital discharge planning services.
HTMLPDF182-550-2900Payment limitsInpatient hospital services.
HTMLPDF182-550-2950Payment limitsProvider preventable fourteen-day readmissions.
HTMLPDF182-550-3000Payment method.
HTMLPDF182-550-3381Payment method for acute PM&R services and administrative day services.
HTMLPDF182-550-3400Case-mix index.
HTMLPDF182-550-3470Payment methodBariatric surgeryPer case rate.
HTMLPDF182-550-3600Diagnosis-related group (DRG) paymentHospital transfers.
HTMLPDF182-550-3700DRG high outliers.
HTMLPDF182-550-3800Rebasing.
HTMLPDF182-550-3830Adjustments to inpatient rates.
HTMLPDF182-550-3850Budget neutrality adjustment and measurement.
HTMLPDF182-550-3900Payment methodBordering city hospitals and critical border hospitals.
HTMLPDF182-550-4000Payment methodOut-of-state hospitals.
HTMLPDF182-550-4100Payment methodNew hospitals.
HTMLPDF182-550-4200Change in hospital ownership.
HTMLPDF182-550-4300Hospitals and units exempt from the DRG payment method.
HTMLPDF182-550-4400ServicesExempt from DRG payment.
HTMLPDF182-550-4500Payment methodRatio of costs-to-charges (RCC).
HTMLPDF182-550-4550Administrative day rate and swing bed day rate.
HTMLPDF182-550-4650"Full cost" public hospital certified public expenditure (CPE) payment program.
HTMLPDF182-550-4670CPE payment program"Hold harmless" provision.
HTMLPDF182-550-4690Authorization requirements and utilization review for hospitals eligible for CPE payments.
HTMLPDF182-550-4800Hospital payment methodsState-administered programs.
HTMLPDF182-550-4900Disproportionate share hospital (DSH) paymentsGeneral provisions.
HTMLPDF182-550-4925Eligibility for DSH programsNew hospital providers.
HTMLPDF182-550-4935DSH eligibilityChange in hospital ownership.
HTMLPDF182-550-4940Disproportionate share hospital independent audit findings and recoupment process.
HTMLPDF182-550-5000Payment methodLow income disproportionate share hospital (LIDSH).
HTMLPDF182-550-5130Payment methodInstitution for mental diseases disproportionate share hospital (IMDDSH) and institution for mental diseases (IMD) state grants.
HTMLPDF182-550-5150Payment methodMedical care services disproportionate share hospital (MCSDSH).
HTMLPDF182-550-5200Payment methodSmall rural disproportionate share hospital (SRDSH).
HTMLPDF182-550-5210Payment methodSmall rural indigent assistance disproportionate share hospital (SRIADSH).
HTMLPDF182-550-5220Payment methodNonrural indigent assistance disproportionate share hospital (NRIADSH).
HTMLPDF182-550-5300Payment methodChildren's health program disproportionate share hospital (CHPDSH).
HTMLPDF182-550-5380Payment methodSole community disproportionate share hospital (SCDSH).
HTMLPDF182-550-5400Payment methodPublic hospital disproportionate share hospital (PHDSH).
HTMLPDF182-550-5410CPE medicaid cost report and settlements.
HTMLPDF182-550-5450Supplemental distributions to approved trauma service centers.
HTMLPDF182-550-5500PaymentHospital-based RHCs.
HTMLPDF182-550-5550Public notice for changes in medicaid payment rates for hospital services.
HTMLPDF182-550-5600Dispute resolution process for hospital rate reimbursement.
HTMLPDF182-550-5700Hospital reports and audits.
HTMLPDF182-550-5800Outpatient and emergency hospital services.
HTMLPDF182-550-6000Outpatient hospital servicesConditions of payment and payment methods.
HTMLPDF182-550-6100Outpatient hospital physical therapy.
HTMLPDF182-550-6150Outpatient hospital occupational therapy.
HTMLPDF182-550-6200Outpatient hospital speech therapy services.
HTMLPDF182-550-6250PregnancyEnhanced outpatient benefits.
HTMLPDF182-550-6300Outpatient nutritional counseling.
HTMLPDF182-550-6400Outpatient hospital diabetes education.
HTMLPDF182-550-6450Outpatient hospital weight loss program.
HTMLPDF182-550-6500Blood and blood components.
HTMLPDF182-550-6600Hospital-based physician services.
HTMLPDF182-550-6700Hospital services provided out-of-state.
HTMLPDF182-550-7000Outpatient prospective payment system (OPPS)General.
HTMLPDF182-550-7200OPPSBilling requirements and payment method.
HTMLPDF182-550-7300OPPSPayment limitations.
HTMLPDF182-550-7400OPPS EAPG relative weights.
HTMLPDF182-550-7450OPPS budget target adjustor.
HTMLPDF182-550-7500OPPS rate.
HTMLPDF182-550-7550OPPS payment enhancements.
HTMLPDF182-550-7600OPPS payment calculation.
HTMLPDF182-550-8000Hospital safety net program (HSNP)Purpose.
HTMLPDF182-550-8100Assessment noticesProcess and timelines.
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