GroundRules
5 CFR 890.905: Limits on inpatient hospital and physician charges.
Where this section sits in the code
- Title 5—Administrative Personnel
- CHAPTER I—OFFICE OF PERSONNEL MANAGEMENT
- SUBCHAPTER B—CIVIL SERVICE REGULATIONS
- PART 890—FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM
- Subpart I—Limit on Inpatient Hospital Charges, Physician Charges, and FEHB Benefit Payments
(a) Hospitals may not collect from FEHB plans and retired enrolled individuals for inpatient hospital services more than the amount determined to be equivalent to the Medicare part A payment under the DRG-based PPS.
(b) Medicare participating providers may not collect from FEHB plans and retired enrolled individuals for physician services more than the amount determined to be equivalent to the Medicare part B payment under the Medicare Participating Physician Fee Schedule.
(c) Medicare nonparticipating providers may not collect from FEHB plans and retired enrolled individuals for physician services more than the amount determined to be equivalent to the Medicare limiting charge amount.
Collected 2026-08-27T02:23:53Z. Source file · JSON