Statutes, codes, and regulations
California Code Of Regulations
Title 22 - Social SecurityDivision 3 - Health Care ServicesSubdivision 1 - California Medical Assistance ProgramChapter 3 - Health Care Services
Article 7 - Payment for Services and Supplies
Section 51511.6 - Nursing Facility Services - Pediatric Subacute Care Reimbursement

Cal. Code Regs. tit. 22 § 51511.6

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Current through Register 2024 Notice Reg. No. 49, December 6, 2024
Section 51511.6 - Nursing Facility Services - Pediatric Subacute Care Reimbursement
(a) The per diem rates of reimbursement for pediatric subacute services as described in Section 51335.6(a) shall be as follows:

LicensureType of PatientRate of
Reimbursement
Effective Rate Year
2004-052005-062006-07
Hospital-basedVentilator Dependent$719.71$762.95$785.01
Hospital-basedNon-ventilator Dependent$660.52$700.10$720.20
FreestandingVentilator Dependent$673.08$713.10$733.52
FreestandingNon-ventilator Dependent$613.89$650.25$668.71

(b) The per diem rate of reimbursement for supplemental rehabilitation therapy services shall be as described below:

Effective Rate YearPer Diem Rate
2004-05$43.13
2005-06$46.05
2006-07$47.46

This rate shall include payment for physical therapy, occupational therapy and speech therapy services provided in accordance with Section 51215.10(i) through (m).

(c) The per diem rate of reimbursement for ventilator weaning services shall be as described below:

Effective Rate YearPer Diem Rate
2004-05$40.21
2005-06$42.94
2006-07$44.25

This rate shall include respiratory care practitioner and nursing care services provided in accordance with Section 51215.11.

(d) Payment to nursing facilities with pediatric subacute units for patients on bedhold receiving acute services shall be in accordance with Section 51535.1(d).
(e) The provisions of Section 51511 shall apply to pediatric subacute units except for Section 51511(a). Section 51511(c) shall apply to pediatric subacute units except as provided for in 51511.6(f).
(f) The pediatric subacute per diem rate includes the following:
(1) Equipment and supplies necessary for continuous intravenous therapy;
(2) Oxygen and all equipment necessary for administration including positive pressure apparatus;
(3) Ventilators, including calibration and maintenance;
(4) Registered Dietician consultant services;
(5) Respiratory therapy services;
(6) Physical, occupational and speech therapy services, as specified in Section 51215.10(h);
(7) Developmental services;
(8) Service Coordinator activities; and
(9) Portable imaging services provided by freestanding providers.

Cal. Code Regs. Tit. 22, § 51511.6

1. New section filed 4-13-94 as an emergency; operative 4-1-94. Emergency adoption submitted to OAL for printing only pursuant to section 4, AB 36 (chapter 1030, Statutes of 1993) (Register 94, No. 15).
2. Certificate of Compliance as to 4-13-94 order including amendment of section transmitted to OAL 9-26-94 and filed 10-20-94 (Register 94, No. 42).
3. Editorial correction of subsection (d)(3) and HISTORY 1 and 2 (Register 95, No. 14).
4. Amendment of subsection (a) and NOTE filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 9-19-96 order transmitted to OAL 1-17-97 and filed 3-3-97 (Register 97, No. 10).
6. Amendment of section and NOTE filed 6-30-97 as an emergency; operative 6-30-97 (Register 97, No. 27). A Certificate of Compliance must be transmitted to OAL by 10-28-97 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 6-30-97 order transmitted to OAL 10-22-97 and filed 11-26-97 (Register 97, No. 48).
8. Amendment of subsections (a)-(c) and amendment of NOTE filed 12-31-97 as an emergency; operative 12-31-97 (Register 98, No. 1). A Certificate of Compliance must be transmitted to OAL by 4-30-98 or emergency language will be repealed by operation of law on the following day.
9. Editorial correction of HISTORY 8 (Register 98, No. 24).
10. Certificate of Compliance as to 12-31-97 order transmitted to OAL 4-27-98 and filed 6-9-98 (Register 98, No. 24).
11. Amendment of subsections (a)-(c) and amendment of NOTE filed 10-29-98 as an emergency; operative 10-29-98 (Register 98, No. 44). A Certificate of Compliance must be transmitted to OAL by 2-26-99 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 10-29-98 order transmitted to OAL 2-26-99 and filed 4-8-99 (Register 99, No. 15).
13. Amendment of subsections (a)-(c) and amendment of NOTE filed 11-3-99 as an emergency; operative 11-3-99 (Register 99, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-2-2000 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 11-3-99 order transmitted to OAL 3-1-2000 and filed 4-6-2000 (Register 2000, No. 14).
15. Amendment of subsections (a)-(c) and amendment of NOTE filed 11-17-2000 as an emergency; operative 11-17-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-19-2001 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 11-17-2000 order transmitted to OAL 3-8-2001 and filed 4-19-2001 (Register 2001, No. 16).
17. Amendment of subsections (a)-(c), new subsection (f)(9) and amendment of NOTE filed 1-27-2003 as an emergency; operative 8-1-2001 pursuant to Statutes of 2002, Chapter 16, Items 4260-101-0001 and 4260-101-0890 (Register 2003, No. 5). A Certificate of Compliance must be transmitted to OAL by 5-27-2003 or emergency language will be repealed by operation of law on the following day.
18. Amendment of subsections (a)-(c), new subsection (f)(9) and amendment of NOTE refiled 5-22-2003 as an emergency; operative 5-22-2003 (Register 2003, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-19-2003 or emergency language will be repealed by operation of law on the following day.
19. Certificate of Compliance as to 5-22-2003 order transmitted to OAL 9-18-2003 and filed 10-16-2003 (Register 2003, No. 42).
20. Amendment of subsections (a)-(c) and amendment of NOTE filed 8-24-2005 as a deemed emergency pursuant to Welfare and Institutions Code section 14105(a); operative 8-24-2005 for dates of service 8-1-2002 through 7-31-2003 pursuant to Statutes of 2002, Chapter 379, Items 4260-101-0001 and 4260-101-0890 (Register 2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-23-2005 or emergency language will be repealed by operation of law on the following day.
21. Certificate of Compliance as to 8-24-2005 order transmitted to OAL 12-22-2005 and filed 1-23-2006 (Register 2006, No. 4).
22. Amendment of subsections (a)-(c) and amendment of NOTE filed 6-24-2010 as an emergency; operative 6-24-2010 (Register 2010, No. 26). A Certificate of Compliance must be transmitted to OAL by 12-21-2010 or emergency language will be repealed by operation of law on the following day.
23. Certificate of Compliance as to 6-24-2010 order transmitted to OAL 11-29-2010 and filed 1-10-2011 (Register 2011, No. 2).
24. Amendment of subsections (a)-(c) and amendment of NOTE filed 12-24-2013 as an emergency; operative 12-24-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-23-2014 or emergency language will be repealed by operation of law on the following day.
25. Certificate of Compliance as to 12-24-2013 order transmitted to OAL 4-15-2014 and filed 5-22-2014 (Register 2014, No. 21).
26. Amendment of subsections (a) and (f)(8)-(9) filed 5-12-2015; operative 7-1-2015 (Register 2015, No. 20).

Note: Authority cited: Section 20, Health and Safety Code; and Sections 10725, 14105 and 14124.5, Welfare and Institutions Code. Reference: Section 14132.25, Welfare and Institutions Code; Statutes of 2004, Chapter 208, Items 4260-101-0001 and 4260-101-0890; Statutes of 2005, Chapter 38, Items 4260-101-0001 and 4260-101-0890; and Statutes of 2006, Chapter 48, Items 4260-101-0001 and 4260-101-0890.

1. New section filed 4-13-94 as an emergency; operative 4-1-94. Emergency adoption submitted to OAL for printing only pursuant to section 4, AB 36 (chapter 1030, Statutes of 1993) (Register 94, No. 15).
2. Certificate of Compliance as to 4-13-94 order including amendment of section transmitted to OAL 9-26-94 and filed 10-20-94 (Register 94, No. 42).
3. Editorial correction of subsection (d)(3) and History 1 and 2 (Register 95, No. 14).
4. Amendment of subsection (a) and Note filed 9-19-96 as an emergency; operative 9-19-96 (Register 96, No. 38). A Certificate of Compliance must be transmitted to OAL by 1-17-97 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 9-19-96 order transmitted to OAL 1-17-97 and filed 3-3-97 (Register 97, No. 10).
6. Amendment of section and Note filed 6-30-97 as an emergency; operative 6-30-97 (Register 97, No. 27). A Certificate of Compliance must be transmitted to OAL by 10-28-97 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 6-30-97 order transmitted to OAL 10-22-97 and filed 11-26-97 (Register 97, No. 48).
8. Amendment of subsections (a)-(c) and amendment of Note filed 12-31-97 as an emergency; operative 12-31-97 (Register 98, No. 1). A Certificate of Compliance must be transmitted to OAL by 4-30-98 or emergency language will be repealed by operation of law on the following day.
9. Editorial correction of History 8 (Register 98, No. 24).
10. Certificate of Compliance as to 12-31-97 order transmitted to OAL 4-27-98 and filed 6-9-98 (Register 98, No. 24).
11. Amendment of subsections (a)-(c) and amendment of Note filed 10-29-98 as an emergency; operative 10-29-98 (Register 98, No. 44). A Certificate of Compliance must be transmitted to OAL by 2-26-99 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 10-29-98 order transmitted to OAL 2-26-99 and filed 4-8-99 (Register 99, No. 15).
13. Amendment of subsections (a)-(c) and amendment of Note filed 11-3-99 as an emergency; operative 11-3-99 (Register 99, No. 45). A Certificate of Compliance must be transmitted to OAL by 3-2-2000 or emergency language will be repealed by operation of law on the following day.
14. Certificate of Compliance as to 11-3-99 order transmitted to OAL 3-1-2000 and filed 4-6-2000 (Register 2000, No. 14).
15. Amendment of subsections (a)-(c) and amendment of Note filed 11-17-2000 as an emergency; operative 11-17-2000 (Register 2000, No. 46). A Certificate of Compliance must be transmitted to OAL by 3-19-2001 or emergency language will be repealed by operation of law on the following day.
16. Certificate of Compliance as to 11-17-2000 order transmitted to OAL 3-8-2001 and filed 4-19-2001 (Register 2001, No. 16).
17. Amendment of subsections (a)-(c), new subsection (f)(9) and amendment of Note filed 1-27-2003 as an emergency; operative 8-1-2001 pursuant to Statutes of 2002, Chapter 16, Items 4260-101-0001 and 4260-101-0890 (Register 2003, No. 5). A Certificate of Compliance must be transmitted to OAL by 5-27-2003 or emergency language will be repealed by operation of law on the following day.
18. Amendment of subsections (a)-(c), new subsection (f)(9) and amendment of Note refiled 5-22-2003 as an emergency; operative 5-22-2003 (Register 2003, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-19-2003 or emergency language will be repealed by operation of law on the following day.
19. Certificate of Compliance as to 5-22-2003 order transmitted to OAL 9-18-2003 and filed 10-16-2003 (Register 2003, No. 42).
20. Amendment of subsections (a)-(c) and amendment of Note filed 8-24-2005 as a deemed emergency pursuant to Welfare and Institutions Code section 14105(a); operative 8-24-2005 for dates of service 8-1-2002 through 7-31-2003 pursuant to Statutes of 2002, Chapter 379, Items 4260-101-0001 and 4260-101-0890 (Register 2005, No. 34). A Certificate of Compliance must be transmitted to OAL by 12-23-2005 or emergency language will be repealed by operation of law on the following day.
21. Certificate of Compliance as to 8-24-2005 order transmitted to OAL 12-22-2005 and filed 1-23-2006 (Register 2006, No. 4).
22. Amendment of subsections (a)-(c) and amendment of Note filed 6-24-2010 as an emergency; operative 6-24-2010 (Register 2010, No. 26). A Certificate of Compliance must be transmitted to OAL by 12-21-2010 or emergency language will be repealed by operation of law on the following day.
23. Certificate of Compliance as to 6-24-2010 order transmitted to OAL 11-29-2010 and filed 1-10-2011 (Register 2011, No. 2).
24. Amendment of subsections (a)-(c) and amendment of Note filed 12-24-2013 as an emergency; operative 12-24-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-23-2014 or emergency language will be repealed by operation of law on the following day.
25. Certificate of Compliance as to 12-24-2013 order transmitted to OAL 4-15-2014 and filed 5/22/2014 (Register 2014, No. 21).
26. Amendment of subsections (a) and (f)(8)-(9) filed 5-12-2015; operative 7/1/2015 (Register 2015, No. 20).