Customary Charges definition

Customary Charges means the amount CONTRACTOR normally or usually charges 35 the majority of its clients for a specified type of service, including the types of Psychiatric Inpatient Hospital Services defined herein. CONTRACTOR’s customary charges shall be 36 subject to review by the Department of Health Care Services.
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Customary Charges as defined in Section 2.12(c).
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Customary Charges is defined in conformity with 42 USC § 1395f and the regulations promulgated pursuant thereto.
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Examples of Customary Charges in a sentence

  • INTENSIVE CARE UNIT - Reimbursement of the Reasonable and Customary Charges Medically Necessary for actual room and board incurred during confinement as an in-patient in the Intensive Care Unit of the Hospital.

  • EMERGENCY ACCIDENTAL OUTPATIENT TREATMENT Reimbursement of the Reasonable and Customary Charges incurred for up to the maximum stated in the Schedule of Benefits, as a result of a covered bodily injury arising from an Accident for Medically Necessary treatment as an outpatient at any registered clinic or hospital within 24 hours of the Accident causing the covered bodily Injury.

  • Reimbursement of the Reasonable and Customary Charges for the first time consultation by a Specialist in connection with a Disability within 60 days preceding confinement in a Hospital and provided that such consultation is Medically Necessary and has been recommended in writing by the attending general practitioner.

  • EMERGENCY ACCIDENTAL OUTPATIENT TREATMENT - Reimbursement of the Reasonable and Customary Charges incurred for up to the maximum stated in the Schedule of Benefits, as a result of a covered bodily injury arising from an Accident for Medically Necessary treatment as an outpatient at any registered clinic or hospital within 24 hours of the Accident causing the covered bodily Injury.

  • IN-HOSPITAL PHYSICIAN VISIT - Reimbursement of the Reasonable and Customary Charges by a Physician for Medically Necessary visiting an in-paying patient while confined for a non-surgical disability subject to a maximum of 1 visit per day not exceeding the maximum number of days as set forth in the Schedule of Benefit.

  • ANAESTHETIST FEE - Reimbursement of the Reasonable and Customary Charges by the Anaesthetist for the Medically Necessary administration of anaesthesia not exceeding the limits as set forth in the Schedule of Benefit.

  • MONTHLY/ANNUAL OUT-PATIENT CANCER TREATMENT - If an Insured is diagnosed with Cancer as defined below, the Company will reimburse the Reasonable and Customary Charges incurred for the Medically Necessary treatment of cancer performed at a legally registered cancer treatment centre subject to the limit of this disability as specified in the Schedule of Benefit.

  • SURGEON FEE - Reimbursement of the Reasonable and Customary Charges for Medically Necessary surgery by the Specialists, including pre-surgical assessment, Specialist’s visits to the Insured Person and post-surgery care up to 60 days inclusive both before and after the date of surgery, but within the maximum indicated in the Schedule of Benefits.

  • HOSPITAL ROOM AND BOARD - Reimbursement of the Reasonable and Customary Charges Medically Necessary for room accommodation and meals.

  • PRE-HOSPITAL DIAGNOSTIC TESTS - Reimbursement of the Reasonable and Customary Charges for Medically Necessary ECG, X-ray and laboratory tests which are performed for diagnostic purposes on account of an injury or illness when in connection with a Disability preceding hospitalisation within 60 days preceding confinement in a Hospital and which are recommended by a qualified medical practitioner.


More Definitions of Customary Charges

Customary Charges means (1) the charges listed in an established charge schedule (if the institution has only a single set of charges applied to all patients), or (2) the most frequent or typical charges imposed (if the institution uses more than one charge for a single service). However, in order to be considered the “customary charge,” a charge would have to be one that was actually collected from a substantial number of individuals. A charge set up in name only, perhaps primarily to avoid the effect of this provision, is not intended to determine Medicare reimbursement.
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Customary Charges means the standard amount a service provider bills on behalf of every patient treated.22 But a “customary” charge is not necessarily a “reasonable” charge that must be reimbursed in full by the insurer.23 “[T]he ‘customary fee’ is simply the cap on what health-care providers can charge, and is not, automatically, a ‘reasonable’ charge requiring full reimbursement under § 3107.”24 The service provider bears the burden of proving both the customariness and the reasonableness of its charges.25
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Related to Customary Charges

  • Usual and Customary Charges means those comparable charges for similar treatment, services and supplies in the geographic area where treatment is performed.

  • Reasonable and Customary Charges means the charges for services or supplies, which are the standard charges for the specific provider and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the illness / injury involved.

  • Monthly Charges means a finance carrying charge of one and one-half of one percent (1.5%) and a storage and handling charge of one-half of one percent (0.5%), in each case of the Cost of the Inventory and/or Special Inventory and/or of the fees for the Product affected by the reschedule or cancellation (as applicable) per month until such Inventory and/or Special Inventory and/or Product is returned to the vendor, used to manufacture Product or is otherwise purchased by Customer.

  • Utility Charges means water, sewer, electricity, gas and other utility charges, if any, applicable to the Real Property or the Leased Real Property;

  • Service Charges means the fees levied by the municipality in terms of its tariff policy for any municipal services rendered in respect of an immovable property and includes any penalties, interest or surcharges levied or imposed in terms of this policy.

  • CCAA Charges means the Administration Charge and the Directors’ Charge;

  • SLDC Charges means the charges levied by the SLDC of the state wherein the Solar Power Project is located.

  • Bond Service Charges means, for any period or payable at any time, the principal of, premium, if any, and interest on the Bonds for that period or payable at that time whether due at maturity or upon redemption, Mandatory Tender or acceleration.

  • Debt Service Charges means for any Measurement Period, the sum of (a) Consolidated Interest Charges required to be paid for such Measurement Period, plus (b) regularly scheduled principal payments required to be made on account of Indebtedness (excluding the Obligations and any Synthetic Lease Obligations and Capital Lease Obligations) for such Measurement Period, in each case determined on a Consolidated basis in accordance with GAAP.

  • Maintenance Charges means the charges payable by the applicant to the Maintenance Agency in accordance with the demand raised by the Maintenance Agency for the maintenance and up keep of the said building/ said complex, including common areas and facilities but does not include; (a) the charges for actual consumption of utilities in the Dwelling Unit including but not limited to electricity, water, which shall be charged based on actual consumption on monthly basis and (b) any statutory payments, taxes, with regard to the Dwelling Unit/ said building/said complex.

  • Usage Charges means the Charges for the Service or applicable part of the Service that are calculated by multiplying the volume of units that the Customer used or incurred in a period (e.g. number of users using the Service, or the number of minutes the Service was used for) with the relevant fee that is specified in the Online Order.

  • Capacity Charge means a charge for public facilities in existence at the time a charge is imposed or charges for new public facilities to be acquired or constructed in the future that are of proportional benefit to the person or property being charged, including supply or capacity contracts for rights or entitlements, real property interests, and entitlements and other rights of the local agency involving capital expense relating to its use of existing or new public facilities. A “capacity charge” does not include a commodity charge.

  • Penalty Charges means any amounts collected from the Borrower that represent default charges, penalty charges, late fees and/or default interest, but excluding any yield maintenance charge or prepayment premium.

  • Installation Charges means those Charges set out in the Order in relation to installation of the Service and/or any Purchased Equipment, Customer Equipment and/or BT Equipment as applicable.

  • Premium surcharge means a payment required from a subscriber, in addition to the subscriber's medical premium contribution, due to an enrollee's tobacco use or an enrolled subscriber's spouse or state registered domestic partner choosing not to enroll in their employer- based group medical when:

  • Service Charge means the amount charged for making a service available on line and is in addition to the actual fee for a service itself. For example, one who renews a license on line will pay the license renewal fee and a service charge.