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Rehabilitation Hospitals Reimbursement

Payment is made at the lesser of the facilities usual and customary fee or the OHCA fixed per diem rate for the rehabilitation level of care.

Replace second paragraph with the following: Payment is made to rehabilitation hospitals for medical services for persons under the age of 21 within the scope of the Authority's Medical Programs, provided the services are reasonable for the diagnosis and treatment of illness or injury, or to improve the functioning of a malformed body member. Medical and surgical services are comparable to those listed for adults except all medically necessary inpatient hospital services, other than psychiatric services, for all persons under the age of 21 will not be limited. All general inpatient hospital services which are not provided under the Diagnosis Related Group (DRG) payment methodology for all persons twenty-one (21) years of age or older is limited to ninety (90) days per person per state fiscal year (July 1 through June 30).  The ninety (90) day limitation applies to both hospital and physician services.  No exceptions or extensions will be made to the ninety (90) day inpatient services limitation.

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Last Modified on Jan 14, 2021
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