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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

LANGLEY PORTER PSYCHIATRIC INSTITUTE

401 PARNASSUS AVENUE
SAN FRANCISCO, CA 94143
http://psych.ucsf.edu/lpphc.aspx

License:

Acute Psychiatric Hospital
Total Beds: 56
Emergency Room: Yes
more... Link to Atlas

Contact:

Ashwini Batchu
(415) 476-7000

OSHPD ID:

106380868

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2015

Download:

Federal Poverty Level for Free Care:

199%

Discount Payment Effective Date:

1/1/2015

Discount Payments

FPL Range: 301%-350%
Payment Basis:
Medicare

FPL Range: 251%-300%
Payment Basis:
Other: 50% of Medicare prevailing rate

FPL Range: 201%-250%
Payment Basis:
Other: 75% of Medicare prevailing rate

Other Discount Payment Information:

Additional consideration included for essential living expense deductions as mandated by SB 1276.

Application Form Information

Application Form Eff Date:

1/1/2015

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: W2 income from previous year, expense proof

Language Information

Available Languages:

English
Other: Interpreter services available in Spanish, Russian

Additional Information

Document updated to be in compliance with SB 1276

Family Size	100%	150%	200%	250%	300%	350%	400%