Current through November 30, 2024
Section 489.32 - Allowable charges: Noncovered and partially covered services(a)Services requested by beneficiary. If services furnished at the request of a beneficiary (or his or her representative) are more expensive than, or in excess of, services covered under Medicare-(1) A provider may charge the beneficiary an amount that does not exceed the difference between- (i) The provider's customary charges for the services furnished; and(ii) The provider's customary charges for the kinds and amounts of services that are covered under Medicare.(2) A provider may not charge for the services unless they have been requested by the beneficiary (or his or her representative) nor require a beneficiary to request services as a condition of admission.(3) To avoid misunderstanding and disputes, a provider must inform any beneficiary who requests a service for which a charge will be made that there will be a specified charge for that service.(b)Services not requested by the beneficiary. For special provisions that apply when a provider customarily furnishes more expensive services, see § 413.35 of this chapter.45 FR 22937, Apr. 4, 1980, as amended at 51 FR 34833, Sept. 30, 1986