[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: 5CFR890.906] [Page 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. 890.906 Retired enrolled individuals coinsurance payments. (a) A retired enrolled individual's coinsurance responsibility for inpatient hospital services is calculated in accordance with the plan's contractual benefit structure and is based on the amount determined to be equivalent to the Medicare part A payment under the DRG-based PPS. (b) A retired enrolled individual's coinsurance responsibility for physician services is calculated in accordance with the plan's contractual benefit structure and is based on the lower of the actual charges or the amount determined to be equivalent to the Medicare part B payment under the Medicare Participating Physician Fee Schedule for Medicare participating physicians and the Medicare Nonparticipating Physician Fee Schedule for Medicare nonparticipating physicians. [60 FR 26668, May 18, 1995]