5 CFR 890.905
§ 890.905 Limits on inpatient hospital and physician charges.
United States · 5 CFR — Administrative Personnel · Status: effective
Cite this
- Citation
- 5 CFR 890.905, § 890.905 Limits on inpatient hospital and physician charges, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/8902
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Full text
(a) Hospitals may not collect from FEHB plans and retired enrolled individuals for inpatient hospital services more than the amount determined to be equivalent to the Medicare part A payment under the DRG-based PPS.
(b) Medicare participating providers may not collect from FEHB plans and retired enrolled individuals for physician services more than the amount determined to be equivalent to the Medicare part B payment under the Medicare Participating Physician Fee Schedule.
(c) Medicare nonparticipating providers may not collect from FEHB plans and retired enrolled individuals for physician services more than the amount determined to be equivalent to the Medicare limiting charge amount.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.