Chapter 182-550 - Hospital services
- Section 182-550-1000 - Applicability
- Section 182-550-1050 - Hospital services definitions
- Section 182-550-1100 - Hospital care-General
- Section 182-550-1200 - Restrictions on hospital coverage
- Section 182-550-1300 - Revenue code categories and subcategories
- Section 182-550-1350 - Revenue code categories and subcategories - CPT and HCPCS reporting requirements for outpatient hospitals
- Section 182-550-1400 - Covered and noncovered revenue codes categories and subcategories for inpatient hospital services
- Section 182-550-1500 - Covered and noncovered revenue code categories and subcategories for outpatient hospital services
- Section 182-550-1600 - Specific items/services not covered
- Section 182-550-1650 - Adverse events, hospital-acquired conditions, and present on admission indicators
- Section 182-550-1700 - Authorization and utilization review (UR) of inpatient and outpatient hospital services
- Section 182-550-1800 - Hospital specialty services not requiring prior authorization
- Section 182-550-1900 - Transplant coverage
- Section 182-550-2100 - Requirements - Transplant hospitals
- Section 182-550-2200 - Transplant requirements-COE
- Section 182-550-2301 - Hospital and medical criteria requirements for bariatric surgery
- Section 182-550-2400 - Inpatient chronic pain management services
- Section 182-550-2431 - Hospice services-Inpatient payments
- Section 182-550-2500 - Inpatient hospice services
- Section 182-550-2501 - Acute physical medicine and rehabilitation (acute PM&R) program-General
- Section 182-550-2511 - [Repealed]
- Section 182-550-2521 - Client eligibility requirements for acute PM&R services
- Section 182-550-2531 - Requirements for becoming an acute PM&R provider
- Section 182-550-2541 - Quality of care-Agency-approved acute PM&R hospital
- Section 182-550-2551 - When the medicaid agency authorizes acute PM&R services
- Section 182-550-2561 - The agency's prior authorization requirements for acute PM&R services
- Section 182-550-2565 - The long-term acute care (LTAC) program-General
- Section 182-550-2570 - [Repealed]
- Section 182-550-2575 - Client eligibility requirements for LTAC services
- Section 182-550-2580 - Requirements for becoming an LTAC hospital
- Section 182-550-2585 - LTAC hospitals-Quality of care
- Section 182-550-2590 - Agency prior authorization requirements for Level 1 and Level 2 LTAC services
- Section 182-550-2595 - Identification of and payment methodology for services and equipment included in the LTAC fixed per diem rate
- Section 182-550-2596 - Services and equipment covered by the agency but not included in the LTAC fixed per diem rate
- Section 182-550-2598 - Critical access hospitals (CAHs)
- Section 182-550-2600 - Inpatient psychiatric services
- Section 182-550-2650 - Base community psychiatric hospitalization payment method for medicaid and CHIP clients and nonmedicaid and non-CHIP clients
- Section 182-550-2750 - Hospital discharge planning services
- Section 182-550-2800 - [Repealed]
- Section 182-550-2900 - Payment limits-Inpatient hospital services
- Section 182-550-2950 - Payment limits-Provider preventable fourteen-day readmissions
- Section 182-550-3000 - Payment method
- Section 182-550-3010 - [Repealed]
- Section 182-550-3020 - [Repealed]
- Section 182-550-3100 - [Repealed]
- Section 182-550-3150 - [Repealed]
- Section 182-550-3200 - [Repealed]
- Section 182-550-3250 - [Repealed]
- Section 182-550-3300 - [Repealed]
- Section 182-550-3350 - [Repealed]
- Section 182-550-3381 - Payment method for acute PM&R services and administrative day services
- Section 182-550-3400 - Case-mix index
- Section 182-550-3450 - [Repealed]
- Section 182-550-3460 - [Repealed]
- Section 182-550-3470 - Payment method-Bariatric surgery-Per case rate
- Section 182-550-3500 - [Repealed]
- Section 182-550-3600 - Diagnosis-related group (DRG) payment-Hospital transfers
- Section 182-550-3700 - DRG high outliers
- Section 182-550-3800 - Rebasing
- Section 182-550-3830 - Adjustments to inpatient rates
- Section 182-550-3840 - [Repealed]
- Section 182-550-3850 - Budget neutrality adjustment and measurement
- Section 182-550-3900 - Payment method - Bordering city hospitals and critical border hospitals
- Section 182-550-4000 - Payment method-Out-of-state hospitals
- Section 182-550-4100 - Payment method-New hospitals
- Section 182-550-4200 - Change in hospital ownership
- Section 182-550-4300 - Hospitals and units exempt from the DRG payment method
- Section 182-550-4400 - Services-Exempt from DRG payment
- Section 182-550-4500 - Payment method-Ratio of costs-to-charges (RCC)
- Section 182-550-4550 - Administrative day rate and swing bed day rate
- Section 182-550-4600 - [Repealed]
- Section 182-550-4650 - "Full cost" public hospital certified public expenditure (CPE) payment program
- Section 182-550-4670 - CPE payment program-"Hold harmless" provision
- Section 182-550-4690 - Authorization requirements and utilization review for hospitals eligible for CPE payments
- Section 182-550-4700 - Payment-Non-SCA participating hospitals (Repealed)
- Section 182-550-4800 - Hospital payment methods- State-administered programs
- Section 182-550-4900 - Disproportionate share hospital (DSH) payments-General provisions
- Section 182-550-4925 - Eligibility for DSH programs-New hospital providers
- Section 182-550-4935 - DSH eligibility-Change in hospital ownership
- Section 182-550-4940 - Disproportionate share hospital independent audit findings and recoupment process
- Section 182-550-5000 - Payment method-Low income disproportionate share hospital (LIDSH)
- Section 182-550-5125 - [Repealed]
- Section 182-550-5130 - Payment method-Institution for mental diseases disproportionate share hospital (IMDDSH) and institution for mental diseases (IMD) state grants
- Section 182-550-5150 - Payment method - Medical care services disproportionate share hospital (MCSDSH)
- Section 182-550-5200 - Payment method-Small rural disproportionate share hospital (SRDSH)
- Section 182-550-5210 - [Repealed]
- Section 182-550-5220 - [Repealed]
- Section 182-550-5300 - Payment method - Children's health program disproportionate share hospital (CHPDSH)
- Section 182-550-5380 - [Repealed]
- Section 182-550-5400 - Payment method-Public hospital disproportionate share hospital (PHDSH)
- Section 182-550-5410 - CPE medicaid cost report and settlements
- Section 182-550-5425 - Upper payment limit (UPL) payments for inpatient hospital services (Repealed)
- Section 182-550-5450 - Supplemental distributions to approved trauma service centers
- Section 182-550-5500 - Payment-Hospital-based RHCs
- Section 182-550-5550 - Public notice for changes in medicaid payment rates for hospital services
- Section 182-550-5600 - Dispute resolution process for hospital rate reimbursement
- Section 182-550-5700 - Hospital reports and audits
- Section 182-550-5800 - Outpatient and emergency hospital services
- Section 182-550-6000 - Outpatient hospital services-Conditions of payment and payment methods
- Section 182-550-6100 - Outpatient hospital physical therapy
- Section 182-550-6150 - Outpatient hospital occupational therapy
- Section 182-550-6200 - Outpatient hospital speech therapy services
- Section 182-550-6250 - Pregnancy-Enhanced outpatient benefits
- Section 182-550-6300 - Outpatient nutritional counseling
- Section 182-550-6400 - Outpatient hospital diabetes education
- Section 182-550-6450 - Outpatient hospital weight loss program
- Section 182-550-6500 - Blood and blood components
- Section 182-550-6600 - Hospital-based physician services
- Section 182-550-6700 - Hospital services provided out-of-state
- Section 182-550-7000 - Outpatient prospective payment system (OPPS) - General
- Section 182-550-7050 - [Repealed]
- Section 182-550-7100 - [Repealed]
- Section 182-550-7200 - OPPS-Billing requirements and payment method
- Section 182-550-7300 - OPPS-Payment limitations
- Section 182-550-7400 - OPPS APC relative weights
- Section 182-550-7450 - OPPS budget target adjustor
- Section 182-550-7500 - OPPS rate
- Section 182-550-7550 - OPPS payment enhancements
- Section 182-550-7600 - OPPS payment calculation
- Section 182-550-8000 - Hospital safety net program (HSNP)-Purpose
- Section 182-550-8100 - Assessment notices-Process and timelines