La. Admin. Code tit. 50 § V-121

Current through Register Vol. 50, No. 11, November 20, 2024

Section V-121 - Distinct Part Psychiatric Units

A. Qualifying Criteria. Reimbursement of psychiatric services (including substance use treatment) provided by acute care general hospitals, long-term acute hospitals, children's hospitals, and rehabilitation hospitals is allowable only for psychiatric services provided in distinct part psychiatric units that meet the following criteria:

1. Medicare prospective payment system (PPS) exempt psychiatric unit criteria in 42 CFR 412.27 and other applicable Medicare guidelines;

2. licensing standards related to hospital psychiatric units/services in LAC 48:I.Chapters 93, 94, and 95; and

3. enrolled in Medicaid and assigned a separate distinct part psychiatric unit provider number.

EXCEPTION: Emergency psychiatric admissions to non-psychiatric inpatient hospitals/units shall be paid the psychiatric rate until the beneficiary can be stabilized and transferred to a psychiatric hospital or unit.

La. Admin. Code tit. 50, § V-121

Promulgated by the Department of Health, Bureau of Health Services Financing, LR 50977 (7/1/2024).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.