PocketLaw
Home
Catalog
Law Online
Teams
Our Free Mobile App
Criteria for Determining Reasonable Charges
Law
CFR 42
Public Health
Centers for Medicare & Medicaid Services, Department of Health and Human Services
Medicare Program
Federal Health Insurance for the Aged and Disabled
Criteria for Determining Reasonable Charges
Checkout our iOS App for a better way to browser and research.
Section
405.500
Basis.
Section
405.501
Determination of reasonable charges.
Section
405.502
Criteria for determining reasonable charges.
Section
405.503
Determining customary charges.
Section
405.504
Determining prevailing charges.
Section
405.505
Determination of locality.
Section
405.506
Charges higher than customary or prevailing charges or lowest charge levels.
Section
405.507
Illustrations of the application of the criteria for determining reasonable charges.
Section
405.508
Determination of comparable circumstances; limitation.
Section
405.509
Determining the inflation-indexed charge.
Section
405.511
Reasonable charges for medical services, supplies, and equipment.
Section
405.512
Carriers' procedural terminology and coding systems.
Section
405.515
Reimbursement for clinical laboratory services billed by physicians.
Section
405.517
Payment for drugs and biologicals that are not paid on a cost or prospective payment basis.
Section
405.520
Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional services.
Section
405.534
Limitation on payment for screening mammography services.
Section
405.535
Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.