ARM 37.86.3109. OUTPATIENT CARDIAC AND PULMONARY REHABILITATION REIMBURSEMENT

(1) Exempt hospital and critical access hospital (CAH) interim reimbursement is based on a hospital specific Medicaid outpatient cost to charge ratio, not to exceed 100%. Exempt hospitals and CAHs will be reimbursed their actual allowable costs determined according to ARM 37.86.2803. (2) Prospective payment hospitals will be reimbursed on a rate-per-service basis using the outpatient prospective payment system (OPPS) schedules as provided in ARM 37.86.3020. (3) Out-of-state hospitals will not be reimbursed for these services.