Examples of Usual and customary rate in a sentence

Section 1551.003, Insurance Code, is amended by adding Subdivision (15) to read as follows:(15) "Usual and customary rate" means the relevant allowable amount as described by the applicable master benefit plan document or policy.SECTION 1.10.
Section 1575.002, Insurance Code, is amended by adding Subdivision (8) to read as follows:(8) "Usual and customary rate" means the relevant allowable amount as described by the applicable master benefit plan document or policy.SECTION 1.13.

More Definitions of Usual and customary rate

Usual and customary rate means the relevant allowable amount as described by the applicable master benefit plan

Usual and customary rate means the eightieth (80th) percentile of all submitted billed charges for the particular healthcare service performed by a provider in the same or similar specialty that are provided in the same geographical area as reported in a benchmarking database maintained by a nonprofit organization that is specified by the commissioner and not affiliated with or has ownership interest by, an insurance carrier or healthcare provider.

Usual and customary rate means the eightieth percentile of all charges for a

Usual and customary rate means the eightieth percentile of all charges for a particular health care service performed by a health care provider in the same or similar specialty and provided in the same geographic region as reported under Section 2 of this Act; and

Usual and customary rate means the median of the contracted rates recognized by the

Usual and customary rate means the median of the contracted rates recognized by the carrier as the total maximum payment, to include the cost-sharing amount imposed for such item or service and the amount to be paid by the carrier for the same or a similar item or service that is provided by a provider in the same or similar specialty and provided in the geographic region in which the item or service is furnished.

Usual and customary rate means the rate which is regularly charged by a vendor for a service that is used by both regional center consumers and/or their families and where at least 30% of the recipients of the given service are not regional center consumers or their families. If more than one rate is charged for a given service, the rate determined to be the usual and customary rate for a regional center consumer and/or family shall not exceed whichever rate is regularly charged to members of the general public who are seeking the service for an individual with a developmental disability who is not a regional center consumer, and any difference between the two rates must be for extra services provided and not imposed as a surcharge to cover the cost of measures necessary for the vendor to achieve compliance with the Americans With Disabilities Act. New programs applying for vendorization shall provide a written declaration to the vendoring regional center that it is their intent to comply with this subsection, and will be allowed up to 12 months to achieve compliance.