Approved State Directed Payment Preprints

Uniform dollar increase for pediatric home health nurses established by the state for home health services for the rating period, July 1, 2025 through June 30, 2026,incorporated into the capitation rates through a separate payment term up to $3,307,280.

The uniform dollar increase for acute care hospitals established by the state for outpatient hospital services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term of up to
$574,278,276.
 

The amendment of the uniform increase for inpatient hospital services provided by Mercer County hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $65,991,813.

 Uniform increase for inpatient and outpatient hospital services at freestanding children’s hospitals with more than 100 licensed pediatric beds for the rating period covering October 1, 2025 through September 30, 2026, and incorporated in the capitation rates through a separate payment term of up to $104,870,000.

Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2025 through September 30, 2026, incorporated into the capitation rate through a separate payment term of up to $388,330,000.

Uniform dollar increase for publicly owned or operated emergency medical transportation provider services for rating period covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a separate payment term amount of up to $66,666,667.

Uniform percentage increase for primary care services and specialty physician services for rating period covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a separate payment term amount of up to $27,099,041.33.

Uniform percentage increase for primary care services and specialty physician services for rating period covering February 1, 2025 through September 30, 2025, incorporated in the capitation rates through a separate payment term amount of up to $54,198,082.67.

Uniform percentage increase for professional services at an academic medical center for rating periods covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a separate payment term amount of up to $113,819,515.

Uniform dollar increase for publicly owned or operated emergency medical transportation provider services for rating period covering February 1, 2025 through September 30, 2025, incorporated in the capitation rates through a separate payment term amount of up to $133,333,334.