Code of Federal Regulations: Containing a Codification of Documents of General Applicability and Future Effect as of December 31, 1948, with Ancillaries and IndexDivision of the Federal Register, the National Archives, 1990 Special edition of the Federal Register, containing a codification of documents of general applicability and future effect ... with ancillaries. |
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Page 39
... reasonable charges . 405.508 Determination of comparable cir- cumstances ; limitation . 405.509 Determining the inflation - indexed charge . 405.511 Reasonable charges for medical services , supplies , and equipment . 405.512 Carriers ...
... reasonable charges . 405.508 Determination of comparable cir- cumstances ; limitation . 405.509 Determining the inflation - indexed charge . 405.511 Reasonable charges for medical services , supplies , and equipment . 405.512 Carriers ...
Page 50
... reasonable cost where the hospital exercises the election as provided for in § 405.521 of this part . Where such election is made : ( 1 ) Direct medical and surgical serv- ices to health insurance program pa- tients , including ...
... reasonable cost where the hospital exercises the election as provided for in § 405.521 of this part . Where such election is made : ( 1 ) Direct medical and surgical serv- ices to health insurance program pa- tients , including ...
Page 51
... reasonable - cost basis . For purposes of this paragraph , reasonable cost is defined as the direct salary paid to such physicians , plus applicable fringe benefits . Such costs must be al- located to such services as provided by ...
... reasonable - cost basis . For purposes of this paragraph , reasonable cost is defined as the direct salary paid to such physicians , plus applicable fringe benefits . Such costs must be al- located to such services as provided by ...
Page 58
... reasonable compensation equivalent ( RCE ) limits on the amount of com- pensation paid to physicians by pro- viders . These limits will be applied to a provider's costs incurred in compensat- ing physicians for services to the pro ...
... reasonable compensation equivalent ( RCE ) limits on the amount of com- pensation paid to physicians by pro- viders . These limits will be applied to a provider's costs incurred in compensat- ing physicians for services to the pro ...
Page 59
... reasonable ( a ) Except as specified in paragraphs ( b ) and ( c ) of this section , Medicare pays no more for Part B medical and other health services than the " rea- sonable charge " for such service . The reasonable charge is ...
... reasonable ( a ) Except as specified in paragraphs ( b ) and ( c ) of this section , Medicare pays no more for Part B medical and other health services than the " rea- sonable charge " for such service . The reasonable charge is ...
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Common terms and phrases
adjustment administrative agency agreement amended amount amount in controversy applicable approved assets basis beneficiary benefits Board carrier chapter claim cluded coinsurance cost reporting period coverage customary charges deductible depreciation dialysis discharges doctor of medicine durable medical equipment effect eligible employees enrollee enrollment period entitled equipment ESRD facility Federal filed fiscal HCFA health maintenance organization hospital insurance hospital's ices individual interim intermediary limits Medi Medicaid Medicare meet ment month nished notice nurse organization outpatient overpayment paid party patient payment rates percent physi physical therapy physician premiums procedures prospective payment system provider provider's qualified reasonable charge reasonable cost Redesignated at 42 reimbursement renal renal dialysis reporting periods beginning request requirements rural health clinic Secretary Sept serv services furnished Social Security Act specified in paragraph speech pathology subpart supplier termination therapist tient tion treatment
Popular passages
Page 144 - B for any expenses incurred for items or services — (1) which are not reasonable and necessary for -the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member...
Page 162 - The fact that the law of war has been violated pursuant to an order of a superior authority, whether military or civil...
Page 204 - The objective is that under the methods of determining costs, the costs with respect to individuals covered by the program will not be borne by individuals not so covered, and the costs with respect to individuals not so covered will not be borne by the program.
Page 298 - ... the Secretary determines to be reasonable, taking into account the range of interest rates prevailing in the private market for similar loans and the risks assumed by the United States...
Page 61 - ... (4) in the case of an agency or organization in any State in which State or applicable local law provides for the licensing of...
Page 124 - ... (1) part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse...
Page 11 - That no charge will be made for the first half hour. (2) Reproduction, duplication, or copying of records. Ten cents per page where such reproduction can be made by commonly available photocopying machines. The cost of reproducing records which cannot be so photocopied will be determined on an individual basis at actual cost. (3) Certification or authentication of records. Three dollars per certification or authentication. (4) Forwarding materials to destination. Any special arrangements for forwarding...
Page 153 - ... (12) where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth. (b) Payment under this title may not be made with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made (as determined in accordance with regulations), with respect to such item or service, under a workmen's compensation law or plan of the United States or a State.
Page 326 - Security for the purpose of reviewing the status of the Federal OldAge and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, the Federal Hospital Insurance Trust Fund...
Page 28 - No certifying or disbursing officer shall be held liable for any amount certified or paid by him to any person where the adjustment or recovery of such amount is waived under subsection (b), or where adjustment under subsection (a) is not completed prior to the death of all persons against whose benefits deductions are authorized.