Chapter 15 - Hospital Program
- § 13 CSR 70-15.010 - [Effective until 2/23/2023] Inpatient Hospital Services Reimbursement Methodology
- § 13 CSR 70-15.010 - [Effective 2/23/2023] Inpatient Hospital Services Reimbursement Methodology, version 2
- § 13 CSR 70-15.011 - Reimbursement for Essential Disproportionate Share Hospitals
- § 13 CSR 70-15.015 - [Effective until 2/23/2023] Direct Medicaid Payments
- § 13 CSR 70-15.015 - [Effective 2/23/2023] Direct Medicaid Payments, version 2
- § 13 CSR 70-15.020 - Procedures for Admission Certification, Continued Stay Review, and Validation Review of Hospital Admissions
- § 13 CSR 70-15.030 - Payment and Payment Limitations for Inpatient Hospital Care
- § 13 CSR 70-15.040 - Hospital Outpatient Settlements
- § 13 CSR 70-15.070 - Inpatient Psychiatric Services for Individuals Under Age Twenty-One
- § 13 CSR 70-15.080 - Payment Method for General Relief Recipient Hospital Outpatient Services
- § 13 CSR 70-15.090 - [Rescinded]
- § 13 CSR 70-15.100 - Unreimbursed Care Payment Methodology
- § 13 CSR 70-15.110 - [Effective until 2/23/2023] Federal Reimbursement Allowance (FRA)
- § 13 CSR 70-15.110 - [Effective 2/23/2023] Federal Reimbursement Allowance (FRA), version 2
- § 13 CSR 70-15.150 - [Rescinded]
- § 13 CSR 70-15.160 - [Effective until 2/23/2023] Outpatient Hospital Services Reimbursement Methodology
- § 13 CSR 70-15.160 - [Effective 2/23/2023] Outpatient Hospital Services Reimbursement Methodology, version 2
- § 13 CSR 70-15.170 - Enhanced Disproportionate Share Payment to Trauma Hospitals for the Cost of Care to the Uninsured Provided by Physicians Not Employed by the Hospital
- § 13 CSR 70-15.180 - Grant to Trauma Hospitals for the Care Provided by Physicians Not Employed by the Hospital
- § 13 CSR 70-15.190 - [Effective until 2/23/2023] Out-of-State Hospital Services Reimbursement Plan
- § 13 CSR 70-15.190 - [Effective 2/23/2023] Out-of-State Hospital Services Reimbursement Plan, version 2
- § 13 CSR 70-15.200 - Payment Policy for a Preventable Serious Adverse Event or Hospital or Ambulatory Surgical Center-Acquired Condition
- § 13 CSR 70-15.220 - [Effective until 2/23/2023] Disproportionate Share Hospital (DSH) Payments
- § 13 CSR 70-15.220 - [Effective 2/23/2023] Disproportionate Share Hospital Payments, version 2
- § 13 CSR 70-15.230 - [Effective until 2/23/2023] Upper Payment Limit (UPL) Payment Methodology
- § 13 CSR 70-15.230 - [Effective 2/23/2023] Supplemental Upper Payment Limit Methodology, version 2
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
- § 13 CSR 70-15.010 - Inpatient Hospital Services Reimbursement Methodology
- § 13 CSR 70-15.011 - Reimbursement for Essential Disproportionate Share Hospitals
- § 13 CSR 70-15.015 - [Effective until3/8/2022]Direct Medicaid Payments
- § 13 CSR 70-15.015 - [Effective until3/31/2022] [Effective3/8/2022]Direct Medicaid Payments, version 2
- § 13 CSR 70-15.015 - [Effective3/31/2022]Direct Medicaid Payments, version 3
- § 13 CSR 70-15.020 - Procedures for Admission Certification, Continued Stay Review and Validation Review of Hospital Admissions
- § 13 CSR 70-15.030 - Payment and Payment Limitations for Inpatient Hospital Care
- § 13 CSR 70-15.040 - [Effective until4/30/2022]Inpatient Hospital and Outpatient Hospital Settlements
- § 13 CSR 70-15.040 - [Effective4/30/2022]Hospital Outpatient Settlements, version 2
- § 13 CSR 70-15.070 - [Effective until3/27/2022]Inpatient Psychiatric Services for Individuals Under Age Twenty-One
- § 13 CSR 70-15.070 - [Effective until3/31/2022] [Effective3/27/2022]Inpatient Hospital Psychiatric Services for Individuals Under Age Twenty-One, version 2
- § 13 CSR 70-15.070 - [Effective3/31/2022]Inpatient Psychiatric Services for Individuals Under Age Twenty-One, version 3
- § 13 CSR 70-15.080 - Payment Method for General Relief Recipient Hospital Outpatient Services
- § 13 CSR 70-15.090 - [Rescinded]
- § 13 CSR 70-15.100 - Unreimbursed Care Payment Methodology
- § 13 CSR 70-15.110 - [Effective until3/8/2022]Federal Reimbursement Allowance (FRA)
- § 13 CSR 70-15.110 - [Effective until4/30/2022] [Effective3/8/2022]Federal Reimbursement Allowance (FRA), version 2
- § 13 CSR 70-15.110 - [Effective4/30/2022]Federal Reimbursement Allowance (FRA), version 3
- § 13 CSR 70-15.150 - [Rescinded]
- § 13 CSR 70-15.160 - [Effective until2/24/2022]Outpatient Hospital Services Reimbursement Methodology
- § 13 CSR 70-15.160 - [Effective until11/30/2021]Prospective Outpatient Hospital Services Reimbursement Methodology, version 2
- § 13 CSR 70-15.160 - [Effective11/30/2021through2/24/2022]Outpatient Hospital Services Reimbursement Methodology, version 3
- § 13 CSR 70-15.170 - Enhanced Disproportionate Share Payment to Trauma Hospitals for the Cost of Care to the Uninsured Provided by Physicians Not Employed by the Hospital
- § 13 CSR 70-15.180 - Grant to Trauma Hospitals for the Care Provided by Physicians Not Employed by the Hospital
- § 13 CSR 70-15.190 - Out-of-State Hospital Services Reimbursement Plan
- § 13 CSR 70-15.200 - Payment Policy for a Preventable Serious Adverse Event or Hospital or Ambulatory Surgical Center-Acquired Condition
- § 13 CSR 70-15.220 - Disproportionate Share Hospital Payments
- § 13 CSR 70-15.230 - Supplemental Upper Payment Limit Methodology