Medicare Managed Care Manual (Pub. 100-16), Ch. 18b § 30.2

Payment by Physician Group on Fee-For-Service Basis

Last amended: 2003Year: 2003Length: 77 wordsOfficial source
30.2- Payment by Physician Group on 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 pays its physicians on a fee-for-service basis, reasonable costs shall not exceed reasonable charges as defined at 42 CFR 405 Subpart E. Subpart E limitations do not apply if the physician group has effective incentives (as defined in 42 CFR 417.802 (b)(ii)(B)) to avoid unnecessary or unduly costly utilization.
Medicare Managed Care Manual (Pub. 100-16), Ch. 18b § 30.2: Payment by Physician Group on Fee-For-Service Basis | Justis AI