C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES › Subpart B—Physicians and Other Practitioners

42 C.F.R. § 414.20

Formula for computing fee schedule amounts

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(a) Participating supplier. The fee schedule amount for a participating supplier for a physician service as defined in § 414.2 is computed as the product of the following amounts:

(1) The RVUs for the service.

(2) The GAF for the fee schedule area.

(3) The CF.

(b) Nonparticipating supplier. The fee schedule amount for a nonparticipating supplier for a physician service as defined in § 414.2 is 95 percent of the fee schedule amount as calculated in paragraph (a) of this section.

[62 FR 59101, Oct. 31, 1997]
Notes of Decisions
Cited in 1 case, 1998–1998 · leading case: Furlong v. Shalala, 156 F.3d 384 (2d Cir. 1998).
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Furlong v. Shalala, 156 F.3d 384 (2d Cir. 1998). “§ 1395w-4(b); 42 C.F.R. § 414.20 . . Because the district court disposed of plaintiffs’ complaint before it had the opportunity to certify a class, we treat this appeal as though it were brought only by the individual physicians.”
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