The Massachusetts Division of Health Care Finance and Policy determines the maximum allowable fees for family planning agency services. Payment is always subject to the conditions, exclusions, and limitations set forth in 130 CMR 421.000. The payment for a service is the lower of the following:

1. (A) the amount specified in the applicable fee schedule of the Division of Health Care Finance and Policy; or
2. (B) the agency's usual and customary fee (if the agency uses a sliding fee scale, this is the highest level of the scale).