§ 1163.458. Payment policies relating to same-calendar-day admissions and discharges.
(a) The Department pays for inpatient stays consisting of an admission with subsequent discharge during the same calendar day.
(b) The services must be provided under this chapter.
(c) The interim payment rate is based on 50% of the inpatient per diem rate on file determined in this chapter.
(d) Payment for ancillary services provided to patients during same- calendar-day stays are included in the interim payment. The hospital may not submit a separate bill for these services.
(e) For auditing purposes each same-calendar-day admission and discharge will be counted as 1/2 day.
(f) Without exception same-calendar-day stays, regardless of the reason for the stay, are subject to § § 1163.471—1163.481 (relating to utilization control) and will be reimbursed only if provided under this section.
Source The provisions of this § 1163.458 adopted June 22, 1984, effective July 1, 1984, 14 Pa.B. 2185.
Cross References This section cited in 55 Pa. Code § 1163.451 (relating to general payment policy); and 55 Pa. Code § 1163.457 (relating to payment policies relating to out-of-State hospitals).
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