Physician Services- General

120 - Physician Services- General (Rev. 4, 10-01-01) Amounts paid by a cost-based HMO/CMP for physicians’ services are allowable to the extent they are reasonable. Different tests of reasonableness apply, depending upon whether the organization employs the physicians directly or pays for physicians’ services on a fee-for-service basis or some other basis. The allowability of physician and other Part B supplier services furnished directly is determined in accordance with §130 of this subchapter. The allowability of physician and other Part B supplier services furnished under arrangements is determined in accordance with the provisions of §140 of this subchapter.