471 NAC 46-005. PAYMENTS FOR PSYCHIATRIC INPATIENT SERVICES

005. PAYMENTS FOR PSYCHIATRIC INPATIENT SERVICES. Payments for psychiatric discharges are made on a prospective per diem basis. Tiered rates will be used for all acute psychiatric inpatient services. This includes services provided at a facility enrolled as a provider for psychiatric services which is not a licensed psychiatric hospital or a Medicare-certified distinct part unit. Payment for each discharge equals the per diem times the number of approved beneficiary days . Payment is made for the day of admission, but not the day of discharge. Tiered rates are subject to annual adjustment as specified by Nebraska Legislative appropriations. 005.01 PAYMENT FOR PSYCHIATRIC ADULT INPATIENT SUBACUTE HOSPITAL SERVICES. Payments for psychiatric adult inpatient subacute hospital services are made on a per diem basis. The subacute inpatient hospital per diem basis is not a tiered rate. Payment will be an all-inclusive per diem basis, with the exception of physician services. Per diem payment amounts are subject to annual adjustment as specified by Nebraska Legislative appropriations. 005.02 PAYMENT FOR HOSPITAL-SPONSORED PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES (PRTF). Reimbursement is capped at the psychiatric residential treatment facilities’ (PRTF) usual and customary daily charges billed for eligible beneficiaries. Public psychiatric residential treatment facilities (PRTF) will be cost-settled annually. Payment rates do not include costs of providing educational, pharmacy, and physician services. Rates are subject to annual adjustment as specified by Nebraska Legislative appropriations.