CMS-179 4.19(a)

Form Approved CMS-179
OMB No. 0938-0193
57
Revision:

HCFA-PM-93-5
AUGUST 1991

(BPD)

OMB No.: 0938-

State/Territory:
Citation

4.19 Payment for Services

42 CFR 447.252
1902(a)(13)
and 1923 of
the Act
1902(e)(7)
of the Act

(a)

The Medicaid agency meets the requirements of
42 CFR Part 447, Subpart C, and sections
1902(a)(13) and 1923 of the Act with respect to
payment for inpatient hospital services.
ATTACHMENT 4.19-A describes the methods and
standards used to determine rates for payment for inpatient
hospital services.
Inappropriate level of care days are covered and are
paid under the State plan at lower rates than other
inpatient hospital services, reflecting the level of care
actually received, in a manner consistent with section
1861(v)(1)(G) of the Act.
Inappropriate level of care days are not covered.

______________________________________________________________________________
TN No.
Supersedes
Approval Date
Effective Date
TN No.
HCFA ID: 7982E
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