Subpart E—Criteria for Determining Reasonable Charges

1. CFR
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3. Title 42
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5. Chapter IV
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7. Part 405
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9. Subpart E

Sections

Section numbering in the official eCFR can be non-consecutive. Omitted section numbers are not treated here as reserved unless the source explicitly labels them that way.

• 405.500
  § 405.500 Basis.
• 405.501
  § 405.501 Determination of reasonable charges.
• 405.502
  § 405.502 Criteria for determining reasonable charges.
• 405.503
  § 405.503 Determining customary charges.
• 405.504
  § 405.504 Determining prevailing charges.
• 405.505
  § 405.505 Determination of locality.
• 405.506
  § 405.506 Charges higher than customary or prevailing charges or lowest charge levels.
• 405.507
  § 405.507 Illustrations of the application of the criteria for determining reasonable charges.
• 405.508
  § 405.508 Determination of comparable circumstances; limitation.
• 405.509
  § 405.509 Determining the inflation-indexed charge.
• 405.511
  § 405.511 Reasonable charges for medical services, supplies, and equipment.
• 405.512
  § 405.512 Carriers' procedural terminology and coding systems.
• 405.515
  § 405.515 Reimbursement for clinical laboratory services billed by physicians.
• 405.517
  § 405.517 Payment for drugs and biologicals that are not paid on a cost or prospective payment basis.
• 405.520
  § 405.520 Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional services.
• 405.534
  § 405.534 Limitation on payment for screening mammography services.
• 405.535
  § 405.535 Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.