Medicare Rate definition

Medicare Rate means the rate of reimbursement established by the Centers for Medicare and Medicaid Services for the Medicare Program.
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Medicare Rate means the aggregate Medicare fee-for-service reimbursement rate for the technical component of all services (including, but not limited to, treatment planning and delivery, but excluding codes specifically related to physics support) related to a procedure performed on the Equipment using CPT code 77371, defined as Stereotactic Radiosurgery Gamma, or any substitutions, replacements and/or supplements thereto (or, if no longer in effect, their respective outpatient rate replacements for Gamma Knife procedures), taking into account, without limitation, any and all new codes, repeals, modifications, changes in interpretation and other adjusting factors, which reimbursement rates are payable to, or entitled to be collected by, Medical Center or its representatives or affiliates from any and all Medicare-related payor sources, including, without limitation, carriers, fiscal intermediaries and any other Medicare-related third party payors. Medical Center represents and warrants to GKF that the difference between the Medicare Rate in effect immediately prior to the Effective Date and the Medicare Rate in effect as of the Effective Date is approximately $4,600. Exhibit 10.22b
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Medicare Rate means the allowable cost of care permitted by Medicare standards and principles of reimbursement.
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Examples of Medicare Rate in a sentence

  • When a code is without a modifier and is notated as BR/RNE, the code is manually priced to mirror the current year Medicare rate.

  • In the absence of the Medicare rate, the rate is determined as the average of available rates from other states.The Nebraska Medicaid Practitioner Fee Schedule is effective July 1 through June 30 of each year.

  • In the absence of the Medicare rate, the rate is determined as the average of available rates from other states.

  • The hospital knowingly and will- fully fails to accept, on a repeated basis, an amount that approximates the Medicare rate established under the inpatient hospital prospective pay- ment system, minus any enrollee deductibles or copayments, as payment in full from a fee-for-service FEHB plan for inpatient hospital services pro- vided to a retired Federal enrollee of a fee-for-service FEHB plan, age 65 or older, who does not have Medicare Part A benefits.

  • Lesser of maximum Medicare rate in effect 6/30/08 plus 1% or maximum Medicaid rate in effect 6/30/08 plus 1%, converted to an hourly rate.

  • The Contractor shall reimburse out-of-network providers at the Medicare rate or, if there is no Medicare rate, at 130% of Medicaid unless other payment arrangements are made.

  • In- network and out-of- network providers will be reimbursed at the applicable Medicare rate for the location in which administration occurred on the date on which the vaccine is administered.

  • Provider category Basis of reimbursement Upper limitHome health agency (provided by nurse)Cost-based rate for nursing services provided by a home health agencyEffective 7/1/16: Lesser of maximum Medicare rate in effect 6/30/16 plus 1%,converted to a 15-minute rate, or maximum Medicaid rate in effect 6/30/16 plus 1%, converted to a 15-minute rate.Child development home or centerFee schedule Effective 7/1/16, provider’s rate in effect 6/30/16 plus 1%, converted to a 15-minute rate.

  • Interim medical monitoring and treatment:Fee schedule Fee schedule in effect 7/1/16.Home health agency (provided by home health aide)Cost-based rate for home health aide services provided by a home health agencyEffective 7/1/16: Lesser of maximum Medicare rate in effect 6/30/16 plus 1%,converted to a 15-minute rate, or maximum Medicaid rate in effect 6/30/16 plus 1%, converted to a 15-minute rate.

  • Contractors shall pay CMHCs at no less than the Medicare rate or 130% of Medicaid FFS rate for any covered non-MRO service that the CMHC provides to a HIP member.


More Definitions of Medicare Rate

Medicare Rate means the rate of reimbursement established
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Related to Medicare Rate

  • Medicare Levy Surcharge means an extra charge payable by high income earners beyond the standard Medicare Levy if they do not have qualifying private hospital insurance coverage. This charge is assessed as part of an individual or family’s annual tax return.

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.

  • Medicare cost report means CMS-2552-10, the cost report for electronic filing of

  • Federal Flood Insurance means federally backed Flood Insurance available under the National Flood Insurance Program to owners of real property improvements located in Special Flood Hazard Areas in a community participating in the National Flood Insurance Program.

  • Medicare Advantage The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422.

  • Medical Reimbursement Programs means a collective reference to the Medicare, Medicaid and TRICARE programs and any other health care program operated by or financed in whole or in part by any foreign or domestic federal, state or local government.

  • Health care facility or "facility" means hospices licensed

  • Health Care Law means any Applicable Law regulating the acquisition, construction, operation, maintenance or management of a health care practice, facility, provider or payor, including without limitation, 42 U.S.C. ss.1395nn and 42 U.S.C. ss. 1320a-7b.

  • Medicare Regulations means, collectively, all Federal statutes (whether set forth in Title XVIII of the Social Security Act or elsewhere) affecting the health insurance program for the aged and disabled established by Title XVIII of the Social Security Act and any statutes succeeding thereto, together with all applicable provisions of all rules, regulations, manuals and orders and administrative, reimbursement and other guidelines having the force of law of all Governmental Authorities (including Health and Human Services (“HHS”), CMS, the Office of the Inspector General for HHS, or any Person succeeding to the functions of any of the foregoing) promulgated pursuant to or in connection with any of the foregoing having the force of law, as each may be amended, supplemented or otherwise modified from time to time.

  • TRICARE means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, and all laws applicable to such programs.

  • Medicaid Regulations means, collectively, (i) all federal statutes (whether set forth in Title XIX of the Social Security Act or elsewhere) affecting the medical assistance program established by Title XIX of the Social Security Act and any statutes succeeding thereto; (ii) all applicable provisions of all federal rules, regulations, manuals and orders of all Governmental Authorities promulgated pursuant to or in connection with the statutes described in clause (i) above and all federal administrative, reimbursement and other guidelines of all Governmental Authorities having the force of law promulgated pursuant to or in connection with the statutes described in clause (i) above; (iii) all state statutes and plans for medical assistance enacted in connection with the statutes and provisions described in clauses (i) and (ii) above; and (iv) all applicable provisions of all rules, regulations, manuals and orders of all Governmental Authorities promulgated pursuant to or in connection with the statutes described in clause (iii) above and all state administrative, reimbursement and other guidelines of all Governmental Authorities having the force of law promulgated pursuant to or in connection with the statutes described in clause (ii) above, in each case as may be amended, supplemented or otherwise modified from time to time.

  • Medicare eligible expenses means expenses of the kinds covered by Medicare Parts A and B, to the extent recognized as reasonable and medically necessary by Medicare.

  • Medicaid Certification means a certification by a state agency or other entity responsible for certifying Medicaid providers and suppliers that a health care provider or supplier is in compliance with all the conditions of participation set forth in the Medicaid Regulations.

  • Medicare Provider Agreement means an agreement entered into between CMS (or other such entity administering the Medicare program on behalf of the CMS) and a health care provider or supplier, under which such health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Health care coverage means any plan providing hospital, medical or surgical care coverage for

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Child abuse means any of the following acts committed in an educational setting by an employee or volunteer against a child:

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Health care facilities means buildings, structures, or equipment suitable and intended for, or incidental or ancillary to, use in providing health services, including, but not limited to, hospitals; hospital long-term care units; infirmaries; sanatoria; nursing homes; medical care facilities; outpatient clinics; ambulatory care facilities; surgical and diagnostic facilities; hospices; clinical laboratories; shared service facilities; laundries; meeting rooms; classrooms and other educational facilities; students', nurses', interns', or physicians' residences; administration buildings; facilities for use as or by health maintenance organizations; facilities for ambulance operations, advanced mobile emergency care services, and limited advanced mobile emergency care services; research facilities; facilities for the care of dependent children; maintenance, storage, and utility facilities; parking lots and structures; garages; office facilities not less than 80% of the net leasable space of which is intended for lease to or other use by direct providers of health care; facilities for the temporary lodging of outpatients or families of patients; residential facilities for use by the aged or disabled; and all necessary, useful, or related equipment, furnishings, and appurtenances and all lands necessary or convenient as sites for the health care facilities described in this subdivision.

  • National Flood Insurance Program means the program created by the U.S. Congress pursuant to the National Flood Insurance Act of 1968 and the Flood Disaster Protection Act of 1973, as revised by the National Flood Insurance Reform Act of 1994, that mandates the purchase of flood insurance to cover real property improvements located in Special Flood Hazard Areas in participating communities and provides protection to property owners through a Federal insurance program.

  • Credit accident and health insurance means insurance on a debtor to provide

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Federal poverty level means the poverty level as defined by the most recently revised poverty income guidelines published by the United States Department of Health and Human Services in the Federal Register.