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405.505 405.506 405.507

Illustrations of the application of the criteria for determining reasonable charges.

405.508 Determination of comparable circumstances; limitation.

405.520 Reimbursement for services of in

terns, residents and supervising physicians; general.

405.521 Services of attending physicians supervising interns and residents. 405.522 Interns' and residents' services in approved teaching programs.

405.523 Interns' and residents' services not in approved teaching programs. 405.524 Interns' and residents' services outside the hospital.

405.525 Basis of reimbursement under the health insurance program for services of interns and residents.

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Subpart F-Agreements With and Functions of Providers, Intermediaries, Carriers, and State Agencies

405.663

405.670

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405.671

Carrier; defined.

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405.672

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405.673

Carrier's ability to perform duties; financial responsibility; etc.

405.605 Provider of services; scope of term. Acceptance of provider as participant.

405.609

405.610

Essentials of agreements with providers of services.

Allowable charges; deductible, coinsurance and copayment. Allowable charges; whole blood costs.

Allowable charges; noncovered and partially covered items or services; prepayment requirements and other charges.

405.612 Compliance with procedural and other requirements; individual's refusal to execute request for payment.

405.613 Termination by provider of services. 405.614 Termination by the Secretary. 405.615 Applicability of termination. 405.616

Reinstatement of provider as participant after termination.

405.675 Termination of section 1842 contract by notice of nonrenewal.

405.676 Termination of section 1842 contract by Secretary for cause.

405.677 Functions which a carrier may perform under contract with the Secretary.

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405.617 Limitation; failure to make timely utilization review.

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Filing for review of initial deter

mination.

405.808

Parties to the review.

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405.809

Opportunity to submit evidence.

moneys incorrectly collected.

405.810

Informal review determination.

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