Usual and customary cost definition

Usual and customary cost means the eightieth percentile of all
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Usual and customary cost means the eightieth percentile of all charges for a particular health care
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Usual and customary cost means the eightieth percentile of all charges for the
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Examples of Usual and customary cost in a sentence

  • The sales price will be reduced by the following: • Usual and customary cost of sale and attorney’s fees.

  • Reemployment Services240:12-5-1 Approval of training 77240:12-5-2 Subsistence and transportation payments 77240:12-5-3 Receipts for reimbursement 77240:12-5-4 Maximum cost of training [Revoked] 77240:12-5-5 Usual and customary cost of training 77Subchapter 7.

  • Reemployment Services240:12-5-1 Approval of training 80240:12-5-2 Subsistence and transportation payments 80240:12-5-3 Receipts for reimbursement 80240:12-5-4 Maximum cost of training [REVOKED] 80240:12-5-5 Usual and customary cost of training 80Subchapter 7.

  • New York’s Emergency Medical Services and Surprise Bills Law – the most successful out-of- network policy in place – defines UCR as: Usual and customary cost means the eightieth percentile of all charges for the particular health care service performed by a provider in the same or similar specialty and provided in the same geographical area as reported in a benchmarking database maintained by a nonprofit 1 New York State Office of the Attorney General.


More Definitions of Usual and customary cost

Usual and customary cost. MEANS THE EIGHTIETH PERCENTILE OF ALL CHARGES FOR THE PARTICULAR HEALTH CARE SERVICE PERFORMED BY A PROVIDER IN THE SAME OR SIMILAR SPECIALTY AND PROVIDED IN THE SAME GEOGRAPHICAL AREA AS REPORTED IN A BENCHMARKING DATABASE MAINTAINED BY A NONPROFIT ORGANIZATION SPECIFIED BY THE SUPERINTENDENT. THE NONPROFIT ORGANIZATION SHALL NOT BE AFFILIATED WITH AN INSURER, A CORPORATION SUBJECT TO ARTI- CLE FORTY-THREE OF THE INSURANCE LAW, A MUNICIPAL COOPERATIVE HEALTH BENEFIT PLAN CERTIFIED PURSUANT TO ARTICLE FORTY-SEVEN OF THE INSURANCE LAW, OR A HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW.
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Usual and customary cost means the 80th percentile of all charges for a particular
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Usual and customary cost means the charges routinely billed by the provider for
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Usual and customary cost means the 80th percentile of all charges for the particular health care service performed by a provider in the same or similar specialty and provided in the same geographical area as reported in a benchmarking database maintained by a nonprofit organization specified by the superintendent, which is not affiliated with a health care plan.
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Related to Usual and customary cost

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

  • Usual and Customary Charge means the average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided.

  • Usual and Customary (U&C) shall mean covered expenses which are identified by the Plan Administrator, taking into consideration the fee(s) which the Provider most frequently charges the majority of patients for the service or supply, the cost to the Provider for providing the services, the prevailing range of fees charged in the same “area” by Providers of similar training and experience for the service or supply, and the Medicare reimbursement rates. The term(s) “same geographic locale” and/or “area” shall be defined as a metropolitan area, county, or such greater area as is necessary to obtain a representative cross-section of Providers, persons or organizations rendering such treatment, services, or supplies for which a specific charge is made. To be Usual and Customary, fee(s) must be in compliance with generally accepted billing practices for unbundling or multiple procedures.

  • 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.

  • Reasonable and Customary means, in relation to a charge for Medical Service, such level which does not exceed the general range of charges being charged by the relevant service providers in the locality where the charge is incurred for similar treatment, services or supplies to individuals with similar conditions, e.g. of the same sex and similar Age, for a similar Disability, as reasonably determined by the Company in utmost good faith. The Reasonable and Customary charges shall not in any event exceed the actual charges incurred.

  • Proprietary Controls means easements or covenants running with the land that (a) limit land, water, or other resource use and/or provide access rights and (b) are created pursuant to common law or statutory law by an instrument that is recorded in the appropriate land records office.

  • Personnel Costs means the costs of researchers, technicians and other supporting staff to the extent employed on the relevant project or activity;

  • Core Business means any material line of business conducted by the Company and its Subsidiaries as of the Closing Date and any business directly related thereto.

  • Branch business means any insurance business transacted by a branch captive insurance company in this State.

  • Fully Burdened Manufacturing Cost means, with respect to any Licensed Product supplied by or on behalf of NVCR to Zai hereunder if such Licensed Product (or any precursor or intermediate thereof) is manufactured by a Third Party manufacturer [***].

  • Fuel Cost Policy means the document provided by a Market Seller to PJM and the Market Monitoring Unit in accordance with PJM Manual 15 and Operating Agreement, Schedule 2, which documents the Market Seller’s method used to price fuel for calculation of the Market Seller’s cost-based offer(s) for a generation resource.

  • insurance business means one or more aspects of the business of selling, issuing or underwriting insurance or reinsurance.

  • Baseline Personnel Security Standard means the pre-employment controls for all civil servants, members of the Armed Forces, temporary staff and government contractors generally.

  • Eligible business means a business located within the counties of Cook, DuPage, Kane, Lake, McHenry or Will in the State of Illinois (the “Six County Region”), and as to which: (1) a majority of the business' fleet is located and used within the Six County Region; and (2) a majority of those vehicles located and used within the Six County Region are alternatively powered vehicles.

  • Overhead means those amounts which are intended to recover a proportion of the Supplier’s or the Key Sub-Contractor’s (as the context requires) indirect corporate costs (including financing, marketing, advertising, research and development and insurance costs and any fines or penalties) but excluding allowable indirect costs apportioned to facilities and administration in the provision of Supplier Personnel and accordingly included within limb (a) of the definition of “Costs”;

  • customary law means any custom having the force of law in the Republic of the Marshall Islands; and includes any Act declaring the customary law;

  • Prudent means economically and otherwise reasonable in light of the social benefits to be derived from the proposed regulated activity provided cost may be considered in deciding what is prudent and further provided a mere showing of expense will not necessarily mean an alternative is imprudent.

  • Personnel data means government data on individuals maintained because the individual is or was an employee or applicant for employment. For purposes of this policy, “employee” includes a volunteer or an independent contractor.

  • Subject Business means the policy or policies that are

  • Processor Personnel means all directors, officers, employees, agents, consultants and Agreementors of the Processor and/or of any Sub-Processor engaged in the performance of its obligations under this Agreement;

  • long-term insurance business means the business of providing or undertaking to provide policy benefits under long-term policies, but does not include -

  • Relevant Business means any business or part thereof howsoever carried on involving the supply of Restricted Goods and/or Services;

  • Locality means the county where the physical work upon

  • Insurance Costs means the sums described in paragraph 1.1 of Part 5 of the Schedule;

  • Medical Expense means an expense incurred at the time a past member or his or her health reimbursement account dependent is furnished the medical care or service. To be considered a medical expense under this act, the expense shall meet all of the following conditions:

  • Working level month (WLM) means an exposure to 1 working level for 170 hours (2,000 working hours per year divided by 12 months per year is approximately equal to 170 hours per month).