42 CFR Subpart E
Criteria for Determining Reasonable Charges
June 11, 2020
§
405.504
Determining prevailing charges
§
405.500
Basis
§
405.501
Determination of reasonable charges
§
405.502
Criteria for determining reasonable charges
§
405.503
Determining customary 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
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