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37.86.3109    OUTPATIENT CARDIAC AND PULMONARY REHABILITATION REIMBURSEMENT

(1) Exempt hospital and critical access hospital (CAH) interim reimbursement is based on a hospital specific Medicaid outpatient cost to charge ratio, not to exceed 100%. Exempt hospitals and CAHs will be reimbursed their actual allowable costs determined according to ARM 37.86.2803.

(2) Prospective payment hospitals will be reimbursed on a rate-per-service basis using the outpatient prospective payment system (OPPS) schedules as provided in ARM 37.86.3020.

(3) Out-of-state hospitals will not be reimbursed for these services.

History: 53-2-201, 53-6-111, MCA; IMP, 53-2-201, 53-6-101, MCA; NEW, 2006 MAR p. 1640, Eff. 6/23/06.

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