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Code of Federal Regulations (Last Updated: November 8, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 412 - Prospective Payment Systems for Inpatient Hospital Services |
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Subpart F - Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices |
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Payment Adjustment for Certain Clinical Trial Cases and Expanded Access Use Immunotherapy |
§ 412.86 - [Reserved]
Latest version.
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§ 412.86 Payment for extraordinarily high-cost day outliers.
For discharges occurring before October 1, 1997, if a discharge that qualifies for an additional payment under the provisions of § 412.82 has charges adjusted to costs that exceed the cost outlier threshold criteria for an extraordinarily high-cost case as set forth in § 412.80(a)(1)(ii), the additional payment made for the discharge is the greater of -
(a) The applicable per diem payment computed under § 412.82 (c) or (d); or
[53 FR 38529, Sept. 30, 1988, as amended at 62 FR 46028, Aug. 29, 1997(b) The payment that would be made under § 412.84 (i) or (j) if the case had not met the day outlier criteria threshold set forth in § 412.80(a)(1)(i).
[Reserved]