471 NAC 46-006. PAYMENT FOR IN-STATE OUTPATIENT HOSPITAL AND EMERGENCY ROOM SERVICES

006. PAYMENT FOR IN-STATE OUTPATIENT HOSPITAL AND EMERGENCY ROOM SERVICES. The starting point for the outpatient hospital and emergency services rate shall be a rate which is determined by: Peer Groups 1 Metro Acute Care Hospitals, 2 Urban Acute Care & Regional Rural Referral Hospitals, 3 Rural Acute Care Hospitals, and 10 Children’s Hospitals Outpatient Rate is the Nebraska Medicaid percentage of cost to charge ratios (CCR), that is, cost divided by charges multiplied by Nebraska Medicaid percentage of allowable charges; Peer Groups 7 Critical Access Hospitals (CAH), and 8 Rural Emergency Hospitals Outpatient Rate is the ancillary and outpatient service cost center’s cost to charge ratio (CCR) up to 100 percent. All outpatient clinical laboratory services must be itemized and identified with the appropriate Healthcare Common Procedure Coding System (HCPCS) procedure codes. Nebraska Medicaid pays for clinical laboratory services at the fee schedule determined by the Centers for Medicare & Medicaid Services (CMS).