Medicare Managed Care Manual (Pub. 100-16), Ch. 18b § 30.1

Payment by HCPP on Other Than Fee-For-Service Basis

Last amended: 2003Year: 2003Length: 88 wordsOfficial source
30.1- Payment by HCPP on Other Than Fee-For-Service Basis (Rev. 30, 09-05-03) • If the HCPP pays a physician group on other than a fee-for-service basis, and that physician group does not pay its physicians on a fee-for-service basis, costs are considered reasonable if they: o Do not exceed those that a prudent and cost conscious buyer would incur to purchase those services; and o Are comparable to costs incurred for similar services furnished by similar physicians or other suppliers in the same or similar geographic area. 5
Medicare Managed Care Manual (Pub. 100-16), Ch. 18b § 30.1: Payment by HCPP on Other Than Fee-For-Service Basis | Justis AI