Customary Charge definition

Customary Charge is the fee for health care services charged by Medical Group that does not exceed the fee Medical Group would ordinarily charge another person regardless of whether the person is a Customer.
Customary Charge. The fee for MHSA Services charged by Provider that does not exceed the fee Provider would ordinarily charge any other person regardless of whether the person is a Member.
Customary Charge means the average charge for a similar service, activity or procedure for non-departmental clients or purchasers by providers whose training and experience is similar to the contractor or subcontractor and are located in the same area. The area considered in determining customary charge shall be as large as necessary to provide a reasonable measure of the market for such services, activities or procedures.

Examples of Customary Charge in a sentence

  • For purposes of this paragraph, Usual and Customary Charge means the amount that the participating pharmacy would have charged You if You were a cash paying customer.

  • Expenses in excess of the Usual and Customary Charge will not be considered eligible.

  • The Co-payment amount or Co-insurance percentage you pay for a Prescription Drug Product will not exceed the Usual and Customary Charge of the Prescription Drug Product.

  • We will determine the Reasonable and Customary Charge for the covered Medical Expense.

  • Your Cost-Sharing will never exceed the Usual and Customary Charge of the Prescription Drug.


More Definitions of Customary Charge

Customary Charge means the usual rates or range of fees charged by health care providers in a given locale or area.
Customary Charge means a charge within the range of usual charges for a given service billed by most providers with similar training and experience taking into consideration the geographic area in which the services are provided and significant regional variations in the cost of services.
Customary Charge means the average charge for a similar service, activity or procedure for non- departmental clients or purchasers by providers whose training and experience is similar to the contractor or subcontractor and are located in the same area. The area considered in determining customary charge shall be as large as necessary to provide a reasonable measure of the market for such services, activities or procedures.
Customary Charge. The fee for health care services charged by Ancillary Provider that does not exceed the fee Ancillary Provider would ordinarily charge another person regardless of whether the person is a Customer. Customer Expenses: Copayments, deductibles or coinsurance that are the financial responsibility of the Customer according to the Customer’s Benefit Plan.
Customary Charge means the average charge for the service or supply in the geographic area concerned, as determined by the Trust Fund Administrator.
Customary Charge means the fee for a medical service which is no greater than the average and prevailing charge for the same service in the same geographic community, or in a geographic community which is similar to that in which the service is rendered.
Customary Charge. The reasonable and customary fees charged by Provider which do not exceed the fees Provider would charge any other person regardless of whether the person is a Member.