PURPOSE: This rule establishes the methodology where a Medicaid maximum a?lowable fee for service is determined on an annual basis by theDivision of Family Seruices.

1. (1) Reimbursement. ‘Title XIX Medicaid reimbursement for covered home health services urovided to elieible individuals shall be made it the lower of:

   1. (A) The provider’s billed charge for the service;
   2. (B) The Title XVIII interim Medicare rate in effect as of the date of service for the billing provider as determined by the Medicare fiscal mtermediary; or
   3. (C) The Medicaid maximum allowable fee for service.

   Auth: sections 207.020, RSMo (Cum. SUPP. 19931,208.152, RSMo (Cum. Supp. 1992),208.153, RSMo (Cum Supp. 19911 of Medical Services

and 208.201, RSMo (Supp. 1987j.’ This rule uas previously filed as 13 CSR 40. 81.057. Original rule filed May 11, 1984, effectiue Aug. II, 1984. Amended: Filed Dec. l&1991, effectiue Aug. 6,1992. *Original authority: 207.020, RSMo (19451, amended 1961, 1965, 1977, 1981, 1982, 1986. 1993; 208.152, RSMo 119671, amended 1969, 1971, 1972, 1973, 1975, 1977, 1978, 1981, 1986, 1988, 1990, 1992; 208.153, RSMo 1196’71, amended 1973, 1989, 1990, 1991; and 208.201, RSMo (19871.

sarirtary Of state