For either participating or nonparticipating facilities, the Medical Assistance Program will pay no more in the aggregate for inpatient hospital services that the amount it is estimated would be paid for the services under the Medicare principles of reimbursement, as set forth in 42 CFR 447.253(b)(2), and/or lesser of reasonable cost or customary charges in 42 CFR 447.250.
12 Va. Admin. Code § 30-70-30
Statutory Authority
Social Security Act Title XIX; 42 CFR Part 430 to end; all other applicable Statutory and regulatory sections.