Article 55Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service
第五十五条（介護予防サービス費等に係る支給限度額）
Total sum of the total amounts of the Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for Preventive Service of Long-Term Care, and the Allowance for Community-Based Preventive Long-Term Care Service and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are paid for Designated Provider of Community-Based Service for Preventive Long-Term Care, as pertaining to a single category of Preventive Service of Long-Term Care, etc., that an In-Home Person Requiring Support receives monthly by category of Preventive Service of Long-Term Care, etc. (which means categories of two or more types as determined by the Minister of Health, Labour, and Welfare, with regard to Preventive Service of Long-Term Care (including equivalent services; the same applies hereinafter in this Article) and Community-Based Preventive Service of Long-Term Care (including equivalent services; the same applies hereinafter in this Article), after considering the inter-substitution by type; the same applies hereinafter in this Article) during the period provided by Order of the Ministry of Health, Labour, and Welfare, may not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare based on the base amount of maximum benefit for the payment categories of Preventive Service of Long-Term Care, etc.
居宅要支援被保険者が介護予防サービス等区分（介護予防サービス（これに相当するサービスを含む。以下この条において同じ。）及び地域密着型介護予防サービス（これに相当するサービスを含む。以下この条において同じ。）について、その種類ごとの相互の代替性の有無等を勘案して厚生労働大臣が定める二以上の種類からなる区分をいう。以下この条において同じ。）ごとに月を単位として厚生労働省令で定める期間において受けた一の介護予防サービス等区分に係る介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護予防サービス費の額の総額並びに地域密着型介護予防サービスにつき支給する地域密着型介護予防サービス費の額の総額及び特例地域密着型介護予防サービス費の額の総額の合計額は、介護予防サービス費等区分支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
The base amount of maximum benefit for the payment categories of Allowance for Preventive Long-Term Care Service, etc., as set forth in the preceding paragraph is to be the amount determined by the Minister of Health, Labour, and Welfare by category of Preventive Service of Long-Term Care, etc., after considering the types of standard use that are according to the categories of Needed Support Condition, of Preventive Service of Long-Term Care, and of Community-Based Preventive Service of Long-Term Care pertaining to the categories of said Preventive Service of Long-Term Care, etc., during the period as determined by Order of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of Article 53, paragraph (2) and each item of Article 54-2, paragraph (2) pertaining to said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care.
前項の介護予防サービス費等区分支給限度基準額は、介護予防サービス等区分ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス等区分に係る介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様、当該介護予防サービス及び地域密着型介護予防サービスに係る第五十三条第二項各号及び第五十四条の二第二項各号の厚生労働大臣が定める基準等を勘案して厚生労働大臣が定める額とする。
A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of the maximum benefit by payment category of Preventive Service of Long-Term Care, etc., as set forth in paragraph (1), may determine that an amount exceeding said base amount as the base amount of maximum benefit by payment category of Preventive Service of Long-Term Care in said Municipality.
A Municipality may stipulate that the total sum of the total amounts of Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for single type of Preventive Service of Long-Term Care and the total amount of Allowance for Community-Based Preventive Long-Term Care Service and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are paid for single type of Community-Based Preventive Service of Long-Term Care as allowances that were paid monthly to an In-Home Person Requiring Support by type of Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care (limited to those types included in categories of Preventive Service of Long-Term Care, etc., and provided by the Minister of Health, Labour, and Welfare; the same applies in the following paragraph) during the period as determined by Order of the Ministry of Health, Labour, and Welfare may not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare based on the base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc.
市町村は、居宅要支援被保険者が介護予防サービス及び地域密着型介護予防サービスの種類（介護予防サービス等区分に含まれるものであって厚生労働大臣が定めるものに限る。次項において同じ。）ごとに月を単位として厚生労働省令で定める期間において受けた一の種類の介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護予防サービス費の額の総額の合計額並びに一の種類の地域密着型介護予防サービスにつき支給する地域密着型介護予防サービス費の額の総額及び特例地域密着型介護予防サービス費の額の総額の合計額について、介護予防サービス費等種類支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができないこととすることができる。
The base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc., as set forth in the preceding paragraph is to be the amount that a Municipality stipulates by ordinance, by type of Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care, after considering the type of standard use that is according to each Category of Needed Support Condition, of said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care during the period as determined by Order of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, standards determined by the Minister of Health, Labour, and Welfare as set forth in each item of Article 53, paragraph (2) and each item of Article 54-2, paragraph (2) pertaining to said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care, etc., within the base amount of maximum benefit by payment category of Preventive Service of Long-Term Care, etc., as set forth in paragraph (1) pertaining to the categories of Preventive Service of Long-Term Care, etc., that include said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care (said base amount, with regard to the Municipality that provides Order pursuant to the provisions of paragraph (3), is to be the amount by which measures pursuant to the provisions of said municipal ordinance are undertaken).
前項の介護予防サービス費等種類支給限度基準額は、介護予防サービス及び地域密着型介護予防サービスの種類ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様、当該介護予防サービス及び地域密着型介護予防サービスに係る第五十三条第二項各号及び第五十四条の二第二項各号の厚生労働大臣が定める基準等を勘案し、当該介護予防サービス及び地域密着型介護予防サービスを含む介護予防サービス等区分に係る第一項の介護予防サービス費等区分支給限度基準額（第三項の規定に基づき条例を定めている市町村にあっては、当該条例による措置が講じられた額とする。）の範囲内において、市町村が条例で定める額とする。
In a case when the total amount as prescribed in paragraph (1) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph or when the total amount as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph by payment of an Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Long-Term Care Service, or an Allowance for Community-Based Preventive Long-Term Care Service or an Exceptional Allowance for Community-Based Preventive Long-Term Care Service, the amount of said Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Long-Term Care Service, or Allowance for Community-Based Preventive Long-Term Care Service or Exceptional Allowance for Community-Based Preventive Long-Term Care Service is to be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provisions of each item of Article 53, paragraph (2), Article 54, paragraph (3), each item of Article 54-2, paragraph (2), paragraph (4) of that Article, or paragraph (2) of the preceding Article.
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