BALTIMORE -- Johns Hopkins University will pay about $450,000 to federal and state medical care programs to settle claims that it submitted improper psychiatric billings.

The U.S. Justice Department made the announcement Friday.

The government alleges that Hopkins' Phipps Clinic had received payments on claims for psychiatric services that were not reimbursable under Medicare, Medicaid and the Civilian Health and Medical Program of the Uniformed Services regulations.

Hopkins officials say the billing regulations have been a matter of confusion and widely varying practice in hospitals across the nation.

The regulations in question require that inpatient psychiatric services be rendered directly to the patient by an attending physician, do not allow reimbursement for services rendered by other health or social service professionals, and require that all services be adequately documented in patient medical records, said Assistant Attorney General Richard Willard, chief of the Justice Department's Civil Division.

Hopkins officials said the issue is a concern for psychiatrists throughout the nation.

A Justice Department spokesman was unable to say how many other medical institutions had been involved in similar disputes, or whether the $450,000 that Hopkins agreed to pay constituted the entire amount involved in the dispute.

The agreement with the Justice Department provides for $17,677 to be returned to the federal Department of Health and Human Sercices, $111,254 to the State of Maryland and $21,069 to the civilian health and medical program.