5 CFR 890.903
§ 890.903 Covered services.
United States · 5 CFR — Administrative Personnel · Status: effective
Cite this
- Citation
- 5 CFR 890.903, § 890.903 Covered services, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/8900
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Full text
(a) The limitation on the charges and FEHB benefit payments for inpatient hospital services apply to inpatient hospital services which are:
(1) Covered under both Medicare part A and the retired enrolled individual's FEHB plan; and
(2) Supplied to a retired enrolled individual who does not have Medicare part A; and
(3) Provided by hospital providers who have in force participation agreements with the Secretary of Health and Human Services (HHS) consistent with sections 1814(a) and 1866 of the Social Security Act, and receive Medicare part A payments in accordance with the diagnosis related group (DRG) based prospective payment system (PPS).
(b) The limitation on the charges and FEHB benefit payments for physician services apply to physician services, (as defined in section 1848(j) of the Social Security Act), which are:
(1) Covered under both Medicare part B and the retired enrolled individual's FEHB plan; and
(2) Supplied to a retired enrolled individual who does not have Medicare part B.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.