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2.2.3 Reasonable Cost and Interim Rates
Outpatient hospital services are reimbursed in accordance with 1 TAC §355.8061. The reimbursement methodology is based on reasonable costs, and providers are reimbursed at an interim rate based on the provider's most recent Medicaid cost report settlement. This interim rate is applied to the provider's allowed amount (per claim detail) to determine the provider's payable amount.
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