US · guidance
CMS Pub. 100-16, ch. mc86c18b, § 40
Physician and Other Part B Supplier Services Not Furnished Under
Arrangements
(Rev. 30, 09-05-03)
Section 1876(j) of the Act places a limit on the charges of noncontracted physicians and
suppliers of End Stage Renal Disease (ESRD) services for enrollees of HCPPs with
§1833 agreement. The HCPP is allowed to use the Medicare FFS payment limits for
these services rendered on or after April 1, 1990. This provision does not preclude the
HCPP from negotiating charges less than the Medicare limits.
6
History
(Rev. 30, 09-05-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
0f82e7664265be90624565c658593ca66bf702b8cce98b2db9a3e17c1e993195
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