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Criteria for Determining Reasonable Charges | Midpage
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Code of Federal Regulations
Title 42
Chapter IV
Subchapter B
Part 405
Subpart E
Criteria for Determining Reasonable Charges
405.500
Basis.
405.501
Determination of reasonable charges.
405.502
Criteria for determining reasonable charges.
405.503
Determining customary charges.
405.504
Determining prevailing charges.
405.505
Determination of locality.
405.506
Charges higher than customary or prevailing charges or lowest charge levels.
405.507
Illustrations of the application of the criteria for determining reasonable charges.
405.508
Determination of comparable circumstances; limitation.
405.509
Determining the inflation-indexed charge.
405.511
Reasonable charges for medical services, supplies, and equipment.
405.512
Carriers' procedural terminology and coding systems.
405.515
Reimbursement for clinical laboratory services billed by physicians.
405.517
Payment for drugs and biologicals that are not paid on a cost or prospective payment basis.
405.520
Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional services.
405.534
Limitation on payment for screening mammography services.
405.535
Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.