GroundRules
42 CFR 447.271: Upper limits based on customary charges.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS
- PART 447—PAYMENTS FOR SERVICES
- Subpart C—Payment for Inpatient Hospital and Long-Term Care Facility Services
(a) Except as provided in paragraph (b) of this section, the agency may not pay a provider more for inpatient hospital services under Medicaid than the provider's customary charges to the general public for the services.
(b) The agency may pay a public provider that provides services free or at a nominal charge at the same rate that would be used if the provider charges were equal to or greater than its costs.
Collected 2026-08-27T02:26:11Z. Source file · JSON