Services Furnished Directly

70.1 - Services Furnished Directly (Rev. 4, 10-01-01) The total allowable cost of Part B physician and supplier services (see Chapter 17, Subpart B, §§120-150) furnished directly shall be apportioned to Medicare on the basis of the ratio of covered Part B services furnished to Medicare enrollees to total services furnished to all the organizations’ enrollees and non-enrolled patients. The HMO/CMP must use a method for reporting costs and statistics that is approved by CMS. CMS will base its approval on findings that the method: • Results in an accurate and equitable allocation of allowable costs; and • Is justifiable from an administrative and cost efficiency standpoint. For example, if the HMO/CMP elects to use a relative value system to apportion costs, the HMO/CMP must use the entire system as described by the designer of the system, and obtain CMS approval before implementation.