Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 70.4.3
Payment Rules for Deemed Providers
70.4.3 - Payment Rules for Deemed Providers
(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)
The payment rules that apply under non-network and full network PFFS plans also apply
for partial network plans. Refer to sections 70.2.2 and 70.3.3 of this chapter.