Out of State Hospital OP CCR Recalculation

Date: 04/25/23

Louisiana Healthcare Connections would like to share with providers guidance received from LDH for Medicaid Outpatient fee schedule changes.

Effective July 1, 2022, approved out of state outpatient services that are listed on the Louisiana Medicaid Outpatient fee schedule as being paid via a CCR shall be paid at a CCR of 0.1525. This ratio shall be applied to the billed charges for covered claims submitted by out-of-state hospitals to determine payment for non-fee schedule services. The out-of-state OP CCR will be recalculated every July 1, going forward. The Medicaid Program does not cost settle out-of-state hospitals.

Louisiana Healthcare Connections will recycle any impacted claims. No action is needed by providers.