Allowable Fee means the maximum charge payable to a Provider for a specific procedure in accordance with the provisions in Article VI of this Contract. The Provider shall charge the usual and customary fee unless the fee schedule limits otherwise.
Allowable Fee means the maximum amount payable to a Facility by EGID and Member for Covered Services furnished pursuant to this Contract.
Allowable Fee means the maximum charge payable to an Oral Surgeon for a specific procedure in accordance with the provisions in Article VI of this Contract. The Oral Surgeon shall charge the usual and customary fee unless the fee schedule limits otherwise.
Examples of Allowable Fee in a sentence
For Covered Services rendered to Enrollees within the PPO Network, Provider will be paid the lower of Provider’s usual fee or InterWest’s Maximum Allowable Fee.
Payment for deluxe prosthetics will be based on the Allowable Fee for a standard prosthesis.
Covered Expense is either the customary and reasonable charge or the Maximum Allowable Fee Schedule for professional services, depending on your plan.
A list of the CPT/HCPCS codes and the Allowable Fee for each can be found on the EGID website.
EGID shall have the right to adjust the Allowable Fee based on clinical editing and/or the use of modifiers as documented in the HealthChoice Provider Manual.
More Definitions of Allowable Fee
Allowable Fee means the maximum charge payable to a PHYSICIAN for a specific procedure in accordance with the provisions in Article VI of this Contract. The PHYSICIAN shall charge the usual and customary fee unless the fee schedule limits otherwise.
Allowable Fee means the maximum amount payable to an ASC in accordance with the provisions in Section VI of this Contract.
Allowable Fee means the maximum charge payable to an Infusion Therapy Provider for a specific procedure in accordance with the provisions in Article VI of this Contract. The Infusion Therapy Provider shall charge the usual and customary fee unless the fee schedule limits otherwise.
Allowable Fee means the maximum fee payable to the Practitioner for a specific procedure in accordance with the provisions in Article VI of this Contract.
Allowable Fee means the maximum charge payable to a Home Health Care Agency for a specific procedure in accordance with the provisions in Article VI of this Contract. The Home Health Care Agency shall charge the usual and customary fee unless the fee schedule limits otherwise.
Allowable Fee means the maximum charge payable to a Durable Medical Equipment Vendor for a specific product in accordance with the provisions in Article VI of this Contract. The Durable Medical Equipment Vendor shall charge the usual and customary fee unless the fee schedule limits otherwise.
Allowable Fee means the maximum charge payable to a Clinical Nurse Specialist for a specific procedure in accordance with the provisions in Article VI of this Contract. The Clinical Nurse Specialist shall charge the usual and customary fee unless the fee schedule limits otherwise.