podiatrist, by a hospital or outpatient clinic which qualifies
to participate under Title XIX of the Social Security Act, to a
patient to whom such hospital or outpatient clinic does not
furnish room, board and professional services on a continuous,
twenty-four hour a day basis.
(1.1) Rates established by the department for observation
services provided by or furnished under the direction of a
physician and furnished by a hospital. Payment for observation
services shall be made in an amount specified by the department
by notice in the Pennsylvania Bulletin and shall be effective
for dates of service on or after July 1, 2016. Payment for
observation services shall be subject to conditions specified in
the department's regulations, including regulations adopted by
the department to implement this paragraph. Pending adoption of
regulations implementing this paragraph, the conditions for
payment of observation services shall be specified in a medical
assistance bulletin.
(2) Rates established by the department for (i) other
laboratory and X-ray services prescribed by a physician,
chiropractor or podiatrist and furnished by a facility other
than a hospital which is qualified to participate under Title
XIX of the Social Security Act, (ii) physician's services
consisting of professional care by a physician, chiropractor or
podiatrist in his office, the patient's home, a hospital, a
nursing facility or elsewhere, (iii) the first three pints of
whole blood, (iv) remedial eye care, as provided in [Article
VIII] subarticle (b) of Article XXII of the act of April 9, 1929
(P.L.177, No.175), known as "The Administrative Code of 1929,"
consisting of medical or surgical care and aids and services and
other vision care provided by a physician skilled in diseases of
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