GroundRules
12VAC30-70-430: Medicare upper limit
Where this section sits in the code
- Title 12. Health
- Agency 30. Department of Medical Assistance Services
- Chapter 70. Methods and Standards for Establishing Payment Rates; In-Patient Hospital Care
- Part V. Inpatient Hospital Payment System
- Article 3. Other Provisions for Payment of Inpatient Hospital Services
For participating and nonparticipating facilities, the state agency will pay no more in the aggregate for inpatient hospital services than 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) or the lesser of reasonable cost or customary charges in 42 CFR 447.250.
Collected 2026-09-14T04:50:59Z. Source file · JSON