MA Payment Guide for Out of Network Payments
Guidance for MA and other Part C organizations in situations where they are required to pay at least the original Medicare rate to out of network providers. This document is a general outline of Medicare payments as of the above date and as such, does not contain many of the payment details.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 15, 2015
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.