[Code of Federal Regulations]
[Title 5, Volume 2]
[Revised as of January 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 5CFR890.905]

[Page 483-484]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
 Subpart I_Limit on Inpatient Hospital Charges, Physician Charges, and 
                          FEHB Benefit Payments
 
Sec. 890.905  Limits on inpatient hospital and physician charges.

    (a) Hospitals may not collect from FEHB plans and retired enrolled 
individuals for inpatient hospital services more than the amount 
determined to be equivalent to the Medicare part A payment under the 
DRG-based PPS.
    (b) Medicare participating providers may not collect from FEHB plans 
and retired enrolled individuals for physician services more than the 
amount determined to be equivalent to the Medicare part B payment under 
the Medicare Participating Physician Fee Schedule.

[[Page 484]]

    (c) Medicare nonparticipating providers may not collect from FEHB 
plans and retired enrolled individuals for physician services more than 
the amount determined to be equivalent to the Medicare limiting charge 
amount.

[60 FR 26668, May 18, 1995; 60 FR 28019, May 26, 1995]