Basis for payment.

§ 416.120 Basis for payment.

The basis for payment depends on where the services are furnished.

(a) Hospital outpatient department. Payment is in accordance with part 419 of this chapter.

(b) [Reserved]

(c) ASC—(1) General rule. Payment is based on a prospectively determined rate. This rate covers the cost of services such as supplies, nursing services, equipment, etc., as specified in § 416.61. The rate does not cover physician services or other medical services covered under part 410 of this chapter (for example, X-ray services or laboratory services) which are not directly related to the performance of the surgical procedures. Those services may be billed separately and paid on a reasonable charge basis.

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