Code of Federal Regulations (Last Updated: November 8, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter B - Medicare Program |
Part 405 - Federal Health Insurance for the Aged and Disabled |
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. |