34 Pa. Code § 127.129 - Out-of-State medical treatment
(a)
When injured employes are treated outside of this Commonwealth by providers who
are licensed by the Commonwealth to provide health care services, the
applicable medical fee cap shall be as follows:
(1) If the provider is both licensed by and
has a place of business within this Commonwealth, the medical fees shall be
capped based on the Medicare reimbursement rate applicable under the Medicare
Program for services rendered at the provider's primary place of business in
this Commonwealth, subject to §
127.152 (relating to medical fee
updates on and after January 1, 1995-generally).
(2) If the provider is licensed by the
Commonwealth to provide health care services but does not have a place of
business within this Commonwealth, medical fees shall be capped based on the
Medicare reimbursement rate applicable in Harrisburg, Pennsylvania, under the
Medicare Program for the services rendered subject to §
127.152.
(b) When injured employes are treated outside
of this Commonwealth by providers who are not licensed by the Commonwealth to
provide health care services, medical fees shall be capped based on the
Medicare reimbursement rate applicable in Harrisburg, Pennsylvania, under the
Medicare Program for the services rendered subject to §
127.152.
Notes
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