US · guidance
CMS Pub. 100-04, ch. 4, § 250.10.2
Payment of Co-surgeon Services Rendered in a Method II
CAH
(Rev. 1781, Issued: 07-29-09; Effective: 01-01-08; Implementation: 07-06-09)
Under Section 1834(g)(2)(B) of the Act outpatient professional services performed in a
Method II CAH are paid 115 percent of such amounts as would otherwise be paid under
the Act if the services were not included in the outpatient CAH services.
Payment for co-surgeon services performed by a physician is based on the lesser of the
actual charges or the reduced fee schedule amount (62.5%) and is calculated as follows:
((facility specific MPFS amount times co-surgery reduction % (62.5%)) minus
(deductible and coinsurance)) times 115%.
History
(Rev. 1781, Issued: 07-29-09; Effective: 01-01-08; Implementation: 07-06-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a7fd6c6ae1c9d874876ace21e0776883fe73920a95ea3f7d2ce6f6c7bcbedad5
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