Payment Method

40.5 - Payment Method (Rev 440, Issued: 01-21-05, Effective: 07-01-05, Implementation: 07-05-05) Pelvic examinations are paid under the MPFS, whether billed to the A/B MAC (A) or (B) except: • Hospital outpatient services are paid under OPPS; • See §40.5.B of this chapter for proper billing by RHC/FQHCs for the professional and technical components of a screening pelvic examination. RHCs/FQHCs are paid under the all-inclusive rate for the professional component; or based on the provider’s payment method for the technical component; • CAH payment is under reasonable cost. NOTE: SNFs are paid under the MPFS and bill the A/B MAC (A). Physicians and other individual practitioners bill the A/B MAC (B).