GENERAL PAYMENT PROVISIONS

1. (a) An HCBS will be paid based on one of the following:

   1. (1) Fee schedule rates.
   2. (2) Cost-based rates.
   3. (3) Department-established fees for the ineligible portion of residential service.
   4. (4) Managed care or other capitated payment methods.
   5. (5) Vendor goods and services.
2. (b) The Department will establish a fee per unit of an HCBS as a Department-established fee by publishing a notice in the Pennsylvania Bulletin.
3. (c) The fee per unit of an HCBS is the maximum amount the Department will pay.
4. (d) The fee per unit of an HCBS applies to a specific location and to a specific HCBS.
5. (e) The provider may not negotiate a different fee or rate with a county mental health and intellectual disability program if there is a fee or rate for the same HCBS at the specific service location.

Cross References

This section cited in 55 Pa. Code § 6100.805 (relating to vendor goods and services).