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Current as of January 01, 2025 | Updated by Findlaw Staff
The maximum payment made to a practitioner for all services provided to an eligible recipient during any one period of inpatient hospitalization shall be the lowest of the following:
(1) The practitioner's usual charge to the general public for the same service.
(2) The medical assistance maximum allowable fee for the service.
(3) A maximum payment limit, per recipient per the period of inpatient hospitalization, established by the medical assistance program and published as a notice in the Pennsylvania Bulletin. If the fee for the actual service exceeds the maximum payment limit, the fee for the actual procedure shall be the maximum payment for the period of inpatient hospitalization.
Cite this article: FindLaw.com - Pennsylvania Statutes Title 62 P.S. Poor Persons and Public Welfare § 443.10. Maximum payment to practitioners for inpatient hospitalization - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-62-ps-poor-persons-and-public-welfare/pa-st-sect-62-443-10/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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