Section 5164.78 | Medicaid payment rates for certain neonatal and newborn services.
(A) The medicaid payment rates for the following neonatal and newborn services shall equal not less than seventy-five per cent of the medicare payment rates for the services in effect on the date the services are provided to medicaid recipients eligible for the services:
(1) Initial care for normal newborns;
(2) Subsequent day, hospital care for normal newborns;
(3) Same day, initial history and physical examination and discharge for normal newborns;
(4) Initial neonatal critical care for children not more than twenty-eight days old;
(5) Subsequent day, neonatal critical care for children not more than twenty-eight days old;
(6) Subsequent day, pediatric critical care for children at least twenty-nine days but less than two years old;
(7) Initial neonatal intensive care;
(8) Subsequent day, neonatal intensive noncritical care for children weighing less than one thousand five hundred grams;
(9) Subsequent day, neonatal intensive noncritical care for children weighing at least one thousand five hundred grams but not more than two thousand five hundred grams;
(10) Subsequent day, neonatal noncritical care for children weighing more than two thousand five hundred grams but not more than five thousand grams.
(B) The medicaid payment rates for other medicaid services selected by the medicaid director shall be less than the amount of the rates in effect on November 22, 2017, so that the cost of the rates set pursuant to division (A) of this section do not increase medicaid expenditures. The director may not select any medicaid service for which the medicaid payment rate is determined in accordance with state statutes.
Last updated October 5, 2023 at 3:24 PM
Available Versions of this Section
- November 22, 2017 – Enacted by House Bill 49 - 132nd General Assembly [ View November 22, 2017 Version ]
- October 3, 2023 – Amended by House Bill 33 - 135th General Assembly [ View October 3, 2023 Version ]