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 182-550-2521. 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. How a client qualifies for 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 182-550-2575. 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 182-550-2900. Payment limits—Inpatient hospital services.

Section 182-550-3000. Payment method.

Section 182-550-3381. Payment method for acute PM&R services and administrative day services.

Section 182-550-3400. Case-mix index.

Section 182-550-3470. Payment method—Bariatric surgery—Per case rate.

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. Payment adjustment for potentially preventable readmissions.

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 182-550-4650. "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.

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 182-550-5130. 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. Payment method—Small rural indigent assistance disproportionate share hospital (SRIADSH).

Section 182-550-5220. Payment method—Nonrural indigent assistance disproportionate share hospital (NRIADSH).

Section 182-550-5300. Payment method—Children's health program disproportionate share hospital (CHPDSH).

Section 182-550-5380. Payment method—Sole community disproportionate share hospital (SCDSH).

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.

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 182-550-7200. OPPS—Billing requirements and payment method.

Section 182-550-7300. OPPS—Payment limitations.

Section 182-550-7400. OPPS EAPG 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.