42 C.F.R. § 412.86 Payment for extraordinarily high-cost day outliers.
Title 42 - Public Health
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 (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). [53 FR 38529, Sept. 30, 1988, as amended at 62 FR 46028, Aug. 29, 1997]
Title 42: Public Health
PART 412—PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES
Subpart F—Payment for Outlier Cases and Special Treatment Payment for New Technology
Payment for Outlier Cases
§ 412.86 Payment for extraordinarily high-cost day outliers.
