Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 488 (January 27, 2024).

55 Pa. Code § 1141.51. General payment policy.

PAYMENT FOR PHYSICIANS’ SERVICES


§ 1141.51. General payment policy.

 Payment is made for covered services provided by participating physicians subject to the conditions and limitations established in Chapter 1101 (relating to general provisions), § §  1141.52—1141.57, 1141.59 and Chapter 1150 (relating to MA Program payment policies). Payment will not be made for a covered physicians’ service if payment is available from another public agency or another insurance or health program.

Authority

   The provisions of this §  1141.51 issued under sections 403(a) and (b), 443.2(1) and (2), 443.3(1) and (2)(i)—(v), 443.4 and 509 of the Public Welfare Code (62 P. S. § §  403(a) and (b), 443.2(1) and (2), 443.3(1), 443.3(2)(i)—(v), 443.4 and 509).

Source

   The provisions of this §  1141.51 adopted August 15, 1980, effective September 1, 1980, 10 Pa.B. 3386; amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932; amended September 7, 1984, effective July 1, 1984, 14 Pa.B. 3252; amended September 30, 1988, effective October 1, 1988, 18 Pa.B. 4418. Immediately preceding text appears at serial page (96100).

Cross References

   This section cited in 55 Pa. Code §  1141.52 (relating to payment conditions for various services).



No part of the information on this site may be reproduced for profit or sold for profit.


This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.