42 CFR 447.325 : Public Health (Part 1 To Parts 1009-1099) — (§ 430.0 To Part 481) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 430.0 To Part 481) — Medical Assistance Programs (§ 430.0 To § 456.725) — Payments For Services (§ 447.1 To § 447.522) — Payment Methods For Other Institutional And Noninstitutional Services (§ 447.300 To § 447.371) — Other Inpatient And Outpatient Facilities (§ 447.325 And § 447.342) — Other inpatient and outpatient facility services: Upper limits of payment.

4 Aug 2016

The agency may pay the customary charges of the provider but must not pay more than the prevailing charges in the locality for comparable services under comparable circumstances.

42 CFR 447.325