Nursing Facility Services--Pediatric Subacute Care Reimbursement.

22 CCR 51511.6

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22 CCR 51511.6

§ 51511.6. Nursing Facility Services--Pediatric Subacute Care Reimbursement. Licensure Type of Patient Rate of Reimbursement Effective Rate Year 2004-05 2005-06 2006-07 Hospital-based Ventilator Dependent $719.71 $762.95 $785.01 Hospital-based Non-ventilator Dependent $660.52 $700.10 $720.20 Freestanding Ventilator Dependent $673.08 $713.10 $733.52 Freestanding Non-ventilator Dependent $613.89 $650.25 $668.71 Effective Rate Year Per Diem Rate 2004-05 $43.13 2005-06 $46.05 2006-07 $47.46 This rate shall include payment for physical therapy, occupational therapy and speech therapy services provided in accordance with Section 51215.10(i) through (m). Effective Rate Year Per Diem Rate 2004-05 $40.21 2005-06 $42.94 2006-07 $44.25 This rate shall include respiratory care practitioner and nursing care services provided in accordance with Section 51215.11.

(a)

The per diem rates of reimbursement for pediatric subacute services as described in Section 51335.6(a) shall be as follows:

(b)

The per diem rate of reimbursement for supplemental rehabilitation therapy services shall be as described below:

(c)

The per diem rate of reimbursement for ventilator weaning services shall be as described below:

(d)

Payment to nursing facilities with pediatric subacute units for patients on bedhold receiving acute services shall be in accordance with Section 51535.1(d).

(e)

The provisions of Section 51511 shall apply to pediatric subacute units except for Section 51511(a). Section 51511(c) shall apply to pediatric subacute units except as provided for in 51511.6(f).

(f)

The pediatric subacute per diem rate includes the following:

(1)

Equipment and supplies necessary for continuous intravenous therapy;

(2)

Oxygen and all equipment necessary for administration including positive pressure apparatus;

(3)

Ventilators, including calibration and maintenance;

(4)

Registered Dietician consultant services;

(5)

Respiratory therapy services;

(6)

Physical, occupational and speech therapy services, as specified in Section 51215.10(h);

(7)

Developmental services;

(8)

Service Coordinator activities; and

(9)

Portable imaging services provided by freestanding providers.

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