A section of the Social Security Amendments of 1972, which places a limit for purposes of Medicare and Medicaid reimbursement on charges recognized as reasonable. The law recognizes as reasonable those charges which fall within the 75th percentile of all charges for a similar service in a locality. Increases in physicians’ fees allowable for Medicare purposes are indexed to a factor which takes into account increased costs of practice and the increase in general earnings levels in an area. Under recently issued regulations the index factor for fiscal 1976 is 1.179. This means that 17.9 percent is the maximum allowable increase under Medicare in any prevailing charge for physicians services in fiscal 1976 over the corresponding charge for the same service in the same locality in the base year, fiscal 1973. Charges for physician services under Medicaid may not exceed this amount. Section 224 further provided that, with respect to reasonable charges for medical supplies and equipment, only the lowest charges at which supplies and equipment of similar quality are widely and consistently available in a locality may be recognized.<\/p>\n
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A section of the Social Security Amendments of 1972, which places a limit for purposes of Medicare and Medicaid reimbursement on charges recognized as reasonable. The law recognizes as reasonable those charges which fall within the 75th percentile of all charges for a similar service in a locality. Increases in physicians’ fees allowable for Medicare […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[],"class_list":["post-81842","post","type-post","status-publish","format-standard","hentry","category-s"],"yoast_head":"\n