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Regulations last checked for updates: Feb 06, 2026
Title 42 - Public Health last revised: Feb 02, 2026
All Titles
Title 42
Chapter IV
Part 405
Subpart E - Subpart E—Criteria for Determining Reasonable Charges
§ 405.500 - Basis.
§ 405.501 - Determination of reasonable charges.
§ 405.502 - Criteria for determining reasonable charges.
§ 405.503 - Determining customary charges.
§ 405.504 - Determining prevailing charges.
§ 405.505 - Determination of locality.
§ 405.506 - Charges higher than customary or prevailing charges or lowest charge levels.
§ 405.507 - Illustrations of the application of the criteria for determining reasonable charges.
§ 405.508 - Determination of comparable circumstances; limitation.
§ 405.509 - Determining the inflation-indexed charge.
§ 405.511 - Reasonable charges for medical services, supplies, and equipment.
§ 405.512 - Carriers' procedural terminology and coding systems.
§ 405.515 - Reimbursement for clinical laboratory services billed by physicians.
§ 405.517 - Payment for drugs and biologicals that are not paid on a cost or prospective payment basis.
§ 405.520 - Payment for a physician assistant's, nurse practitioner's, and clinical nurse specialists' services and services furnished incident to their professional services.
§ 405.534 - Limitation on payment for screening mammography services.
§ 405.535 - Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.
authority:
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