US · guidance
CMS Pub. 100-16, ch. mc86c18b, § 30.1
Payment by HCPP on Other Than Fee-For-Service Basis
• If the HCPP pays a physician group on other than a fee-for-service basis, and that
physician group does not pay its physicians on a fee-for-service basis, costs are
considered reasonable if they:
o Do not exceed those that a prudent and cost conscious buyer would incur
to purchase those services; and
o Are comparable to costs incurred for similar services furnished by similar
physicians or other suppliers in the same or similar geographic area.
5
History
(Rev. 30, 09-05-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
a613aa95b1e8f460e369781ea4ff0de742a635f42217160a9915ca4e377b54e7
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