US · guidance
CMS Pub. 100-04, ch. 12, § 110.3
Outpatient Mental Health Treatment Limitation
In general, payment for covered PA services is made at 80 percent of the lesser of the
actual charge or 85 percent of what a physician is paid under the Medicare Physician Fee
Schedule. The A/B MAC (B) must apply the outpatient mental health treatment
limitation (the limitation) to all covered mental health therapeutic services furnished by
PAs.
Refer to §210 below for a complete discussion of the limitation.
History
(Rev. 2656, Issuance: 02-07-13, Effective: 02-19-13, Implementation: 02-19-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
dd268066f091295ef8c75f77d42cad238aeb3ebc46440768088e1edd5960bb04
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.