Payment by HCPP on Fee-For-Service Basis

30.3 Payment by HCPP on Fee-For-Service Basis (Rev. 30, 09-05-03) If the HCPP pays for physician and other Part B services on a fee-for-service basis, costs are considered reasonable if they do not exceed: • Reasonable charges for those services as defined in Subpart E of Part 405 of 42 CFR; and • The amount CMS would pay for those services if they were furnished to beneficiaries not enrolled in the HCPP and services from sources not reimbursed on a reasonable cost basis. Fee-for service payments to a physician group organized on an individual-practice basis are not subject to the above definition of reasonableness if the physician group pays its physicians on a fee-for-service basis and meets the effective incentive definition of 42 CFR 417.802(b)(2)(ii)(B).