# What SHA rules apply to psychiatric inpatient and rehabilitation claims?

URL: https://tymirahealth.com/resources/faqs/what-sha-rules-apply-to-psychiatric-inpatient-and-rehabilitation-claims
For: Clinicians | Billing and payments | Reviewed by Independent clinical reviewer, Registered mental health clinician, Kenya | Last reviewed 8 November 2026

**Answer:** Under the 2024 published tariffs, inpatient behavioural care is paid per day by facility level, with a limit of up to 35 days. Admission for drug and substance rehabilitation must be pre-authorised, and partial reimbursement applies if a beneficiary does not complete the programme. Beneficiaries must be paid-up members. SHA contracts state that services within the package and tariff are paid in full, so providers may not charge beneficiaries extra for them.

Sources: Ministry of Health, Kenya: https://health.go.ke/sites/default/files/2024-06/Tariffs%20to%20the%20Benefit%20Package%20under%20the%20Social%20Health%20Insurance%20Act.pdf - Social Health Authority: https://www.sha.go.ke/wp-content/uploads/2026/09/03-PART-B2-Social-Health-Insurance-Fund-Contract.pdf

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