Rates of Payment to Chronic Disease, Rehabilitation, or Similar Hospitals with Both Out-of-

state Inpatient Facilities and In-state Outpatient Facilities Payment to a chronic disease, rehabilitation, or similar hospital with both out-of-state inpatient facilities and in-state outpatient facilities, for any medical service payable by the MassHealth agency is made as follows: (A) Inpatient Services. For inpatient services, payment is in accordance with 130 CMR 435.405(B). (B) Outpatient Services. (1) For outpatient services provided out-of-state, payment is in accordance with 130 CMR 450.233(A) and (B). (2) For outpatient services provided in-state, payment is the median in-state outpatient hospital cost-to-charge ratio for similar hospitals.