US · guidance
CMS Pub. 100-16, ch. mc86c17c, § 90
Emergency and Urgently Needed Medical Services and Other
Covered Medical Services for Which the Cost-Based HMO/CMP
Assumes Financial Responsibility
(Rev. 17, 01-01-03)
Payments for services to non-plan physicians and suppliers for purchased services, such
as emergency or urgently needed care outside the HMO/CMP or unusual specialty
services not available within the HMO/CMP, are apportioned to Medicare enrollees in
accordance with the principles set forth in section 70 of this chapter. In most cases, this
will limit CMS’s payment to the HMO/CMP to what the FFS system would have paid for
the service in that area.
History
(Rev. 17, 01-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
2b243a1653bc5d702d327e505ca1fa4d6d1916f87044db5e86e3001e6172dfc1
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