2. Determination of amount of reasonable charge

Official source

The reasonable charge will be based on the services furnished and materials used, up to the date the supplier learned of the beneficiary's death or of the cancellation of the order or that the item was no longer medically necessary or appropriate. The carrier should determine the services performed and the amount of reasonable charge appropriate in the particular situation. The carrier should take into account any salvage value of the device to the supplier.

Where a supplier breaches an agreement to make a prosthesis, brace or other custom-made device for a Medicare beneficiary, e.g., an unexcused failure to provide the article within the time specified in the contract, payment may not be made for any work or material expended on the item. Whether a particular supplier has lived up to its agreement, of course, depends on the facts in the individual case.

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2. Determination of amount of reasonable charge

Official source

The reasonable charge will be based on the services furnished and materials used, up to the date the supplier learned of the beneficiary's death or of the cancellation of the order or that the item was no longer medically necessary or appropriate. The carrier should determine the services performed and the amount of reasonable charge appropriate in the particular situation. The carrier should take into account any salvage value of the device to the supplier.

Where a supplier breaches an agreement to make a prosthesis, brace or other custom-made device for a Medicare beneficiary, e.g., an unexcused failure to provide the article within the time specified in the contract, payment may not be made for any work or material expended on the item. Whether a particular supplier has lived up to its agreement, of course, depends on the facts in the individual case.