HTMLPDF | 182-550-1000 | Applicability. |
HTMLPDF | 182-550-1050 | Hospital services definitions. |
HTMLPDF | 182-550-1100 | Hospital care—General. |
HTMLPDF | 182-550-1200 | Restrictions on hospital coverage. |
HTMLPDF | 182-550-1300 | Revenue code categories and subcategories. |
HTMLPDF | 182-550-1350 | Revenue code categories and subcategories—CPT and HCPCS reporting requirements for outpatient hospitals. |
HTMLPDF | 182-550-1400 | Covered and noncovered revenue codes categories and subcategories for inpatient hospital services. |
HTMLPDF | 182-550-1500 | Covered and noncovered revenue code categories and subcategories for outpatient hospital services. |
HTMLPDF | 182-550-1600 | Specific items/services not covered. |
HTMLPDF | 182-550-1650 | Adverse events, hospital-acquired conditions, and present on admission indicators. |
HTMLPDF | 182-550-1700 | Authorization and utilization review (UR) of inpatient and outpatient hospital services. |
HTMLPDF | 182-550-1800 | Hospital specialty services not requiring prior authorization. |
HTMLPDF | 182-550-1900 | Transplant coverage. |
HTMLPDF | 182-550-2100 | Requirements—Transplant hospitals. |
HTMLPDF | 182-550-2200 | Transplant requirements—COE. |
HTMLPDF | 182-550-2301 | Hospital and medical criteria requirements for bariatric surgery. |
HTMLPDF | 182-550-2400 | Inpatient chronic pain management services. |
HTMLPDF | 182-550-2431 | Hospice services—Inpatient payments. |
HTMLPDF | 182-550-2500 | Inpatient hospice services. |
HTMLPDF | 182-550-2501 | Acute physical medicine and rehabilitation (acute PM&R) program—General. |
HTMLPDF | 182-550-2521 | Client eligibility requirements for acute PM&R services. |
HTMLPDF | 182-550-2531 | Requirements for becoming an acute PM&R provider. |
HTMLPDF | 182-550-2541 | Quality of care—Agency-approved acute PM&R hospital. |
HTMLPDF | 182-550-2551 | When the medicaid agency authorizes acute PM&R services. |
HTMLPDF | 182-550-2561 | The agency's prior authorization requirements for acute PM&R services. |
HTMLPDF | 182-550-2565 | The long-term acute care (LTAC) program—General. |
HTMLPDF | 182-550-2575 | Client eligibility requirements for LTAC services. |
HTMLPDF | 182-550-2580 | Requirements for becoming an LTAC hospital. |
HTMLPDF | 182-550-2585 | LTAC hospitals—Quality of care. |
HTMLPDF | 182-550-2590 | Agency prior authorization requirements for Level 1 and Level 2 LTAC services. |
HTMLPDF | 182-550-2595 | Identification of and payment methodology for services and equipment included in the LTAC fixed per diem rate. |
HTMLPDF | 182-550-2596 | Services and equipment covered by the agency but not included in the LTAC fixed per diem rate. |
HTMLPDF | 182-550-2598 | Critical access hospitals (CAHs). |
HTMLPDF | 182-550-2600 | Inpatient psychiatric services. |
HTMLPDF | 182-550-2650 | Base community psychiatric hospitalization payment method for medicaid and CHIP clients and nonmedicaid and non-CHIP clients. |
HTMLPDF | 182-550-2750 | Hospital discharge planning services. |
HTMLPDF | 182-550-2900 | Payment limits—Inpatient hospital services. |
HTMLPDF | 182-550-2950 | Payment limits—Provider preventable fourteen-day readmissions. |
HTMLPDF | 182-550-3000 | Payment method. |
HTMLPDF | 182-550-3381 | Payment method for acute PM&R services and administrative day services. |
HTMLPDF | 182-550-3400 | Case-mix index. |
HTMLPDF | 182-550-3470 | Payment method—Bariatric surgery—Per case rate. |
HTMLPDF | 182-550-3600 | Diagnosis-related group (DRG) payment—Hospital transfers. |
HTMLPDF | 182-550-3700 | DRG high outliers. |
HTMLPDF | 182-550-3800 | Rebasing. |
HTMLPDF | 182-550-3830 | Adjustments to inpatient rates. |
HTMLPDF | 182-550-3850 | Budget neutrality adjustment and measurement. |
HTMLPDF | 182-550-3900 | Payment method—Bordering city hospitals and critical border hospitals. |
HTMLPDF | 182-550-4000 | Payment method—Out-of-state hospitals. |
HTMLPDF | 182-550-4100 | Payment method—New hospitals. |
HTMLPDF | 182-550-4200 | Change in hospital ownership. |
HTMLPDF | 182-550-4300 | Hospitals and units exempt from the DRG payment method. |
HTMLPDF | 182-550-4400 | Services—Exempt from DRG payment. |
HTMLPDF | 182-550-4500 | Payment method—Ratio of costs-to-charges (RCC). |
HTMLPDF | 182-550-4550 | Administrative day rate and swing bed day rate. |
HTMLPDF | 182-550-4650 | "Full cost" public hospital certified public expenditure (CPE) payment program. |
HTMLPDF | 182-550-4670 | CPE payment program—"Hold harmless" provision. |
HTMLPDF | 182-550-4690 | Authorization requirements and utilization review for hospitals eligible for CPE payments. |
HTMLPDF | 182-550-4800 | Hospital payment methods—State-administered programs. |
HTMLPDF | 182-550-4900 | Disproportionate share hospital (DSH) payments—General provisions. |
HTMLPDF | 182-550-4925 | Eligibility for DSH programs—New hospital providers. |
HTMLPDF | 182-550-4935 | DSH eligibility—Change in hospital ownership. |
HTMLPDF | 182-550-4940 | Disproportionate share hospital independent audit findings and recoupment process. |
HTMLPDF | 182-550-5000 | Payment method—Low income disproportionate share hospital (LIDSH). |
HTMLPDF | 182-550-5130 | Payment method—Institution for mental diseases disproportionate share hospital (IMDDSH) and institution for mental diseases (IMD) state grants. |
HTMLPDF | 182-550-5150 | Payment method—Medical care services disproportionate share hospital (MCSDSH). |
HTMLPDF | 182-550-5200 | Payment method—Small rural disproportionate share hospital (SRDSH). |
HTMLPDF | 182-550-5210 | Payment method—Small rural indigent assistance disproportionate share hospital (SRIADSH). |
HTMLPDF | 182-550-5220 | Payment method—Nonrural indigent assistance disproportionate share hospital (NRIADSH). |
HTMLPDF | 182-550-5300 | Payment method—Children's health program disproportionate share hospital (CHPDSH). |
HTMLPDF | 182-550-5380 | Payment method—Sole community disproportionate share hospital (SCDSH). |
HTMLPDF | 182-550-5400 | Payment method—Public hospital disproportionate share hospital (PHDSH). |
HTMLPDF | 182-550-5410 | CPE medicaid cost report and settlements. |
HTMLPDF | 182-550-5450 | Supplemental distributions to approved trauma service centers. |
HTMLPDF | 182-550-5500 | Payment—Hospital-based RHCs. |
HTMLPDF | 182-550-5550 | Public notice for changes in medicaid payment rates for hospital services. |
HTMLPDF | 182-550-5600 | Dispute resolution process for hospital rate reimbursement. |
HTMLPDF | 182-550-5700 | Hospital reports and audits. |
HTMLPDF | 182-550-5800 | Outpatient and emergency hospital services. |
HTMLPDF | 182-550-6000 | Outpatient hospital services—Conditions of payment and payment methods. |
HTMLPDF | 182-550-6100 | Outpatient hospital physical therapy. |
HTMLPDF | 182-550-6150 | Outpatient hospital occupational therapy. |
HTMLPDF | 182-550-6200 | Outpatient hospital speech therapy services. |
HTMLPDF | 182-550-6250 | Pregnancy—Enhanced outpatient benefits. |
HTMLPDF | 182-550-6300 | Outpatient nutritional counseling. |
HTMLPDF | 182-550-6400 | Outpatient hospital diabetes education. |
HTMLPDF | 182-550-6450 | Outpatient hospital weight loss program. |
HTMLPDF | 182-550-6500 | Blood and blood components. |
HTMLPDF | 182-550-6600 | Hospital-based physician services. |
HTMLPDF | 182-550-6700 | Hospital services provided out-of-state. |
HTMLPDF | 182-550-7000 | Outpatient prospective payment system (OPPS)—General. |
HTMLPDF | 182-550-7200 | OPPS—Billing requirements and payment method. |
HTMLPDF | 182-550-7300 | OPPS—Payment limitations. |
HTMLPDF | 182-550-7400 | OPPS EAPG relative weights. |
HTMLPDF | 182-550-7450 | OPPS budget target adjustor. |
HTMLPDF | 182-550-7500 | OPPS rate. |
HTMLPDF | 182-550-7550 | OPPS payment enhancements. |
HTMLPDF | 182-550-7600 | OPPS payment calculation. |
HTMLPDF | 182-550-8000 | Hospital safety net program (HSNP)—Purpose. |
HTMLPDF | 182-550-8100 | Assessment notices—Process and timelines. |