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  • Code of Federal Regulations
  • C.F.R. Title 42—Public Health
  • CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
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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.

About SCCE

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The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

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About HCCA

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The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

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