42 CFR 417.546 – Physicians’ services and other Part B supplier services furnished under arrangements
Current as of: 2024 | Check for updates
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General principle. The amount paid by an HMO or CMP for physicians’ services and other Part B supplier services furnished under arrangements is an allowable cost to the extent it is reasonable. Costs are considered reasonable if they—
(a) Do not exceed those that a prudent and cost-conscious buyer would incur to purchase those services; and
(b) Are comparable to costs incurred for similar services furnished by similar physicians or other suppliers in the same or a similar geographic area.