Customary Charge definition

Customary Charge is the fee for health care services charged by Medical Group that does not exceed the fee Medical Group would ordinarily charge another person regardless of whether the person is a Customer.

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Customary Charge. The fee for MHSA Services charged by Provider that does not exceed the fee Provider would ordinarily charge any other person regardless of whether the person is a Member.

Customary Charge means the average charge for a similar service, activity or procedure for non-departmental clients or purchasers by providers whose training and experience is similar to the contractor or subcontractor and are located in the same area. The area considered in determining customary charge shall be as large as necessary to provide a reasonable measure of the market for such services, activities or procedures.

Examples of Customary Charge in a sentence

• The Co-payment amount or Co-insurance percentage you pay for a Prescription Drug Product will not exceed the Usual and Customary Charge of the Prescription Drug Product.

• We will determine the Reasonable and Customary Charge for the covered Medical Expense.

• Payment shall be the lesser of: (a) Provider's Customary Charge, less any applicable Member Expenses; or (b) the Fee Maximum for such MHSA Services, less any applicable Member Expenses.

• For Prescription Drugs purchased at a retail or mail order Network Pharmacy, You are responsible for paying the lower of: • The applicable Cost-Sharing; or • The Network Pharmacy’s Usual and Customary Charge (which includes a dispensing fee and sales tax) for the Prescription Drug.

• We will pay up to 80% of the Usual and Customary Charge for each covered Accident or Illness up to the applicable maximum benefit per Incident for Claims resulting from charges incurred for covered veterinary services for the Pet(s) that first occur and are treated by a licensed veterinarian during the Policy Term.

More Definitions of Customary Charge

Customary Charge means the usual rates or range of fees charged by health care providers in a given locale or area.

Customary Charge means the usual rates or range of fees charged by healthcare providers in a given locale or area.

Customary Charge means the average charge for a similar service, activity or procedure for non- departmental clients or purchasers by providers whose training and experience is similar to the contractor or subcontractor and are located in the same area. The area considered in determining customary charge shall be as large as necessary to provide a reasonable measure of the market for such services, activities or procedures.

Customary Charge means a charge within the range of usual charges for a given service billed by most providers with similar training and experience taking into consideration the geographic area in which the services are provided and significant regional variations in the cost of services.

Customary Charge means the fee for a medical service which is no greater than the average and prevailing charge for the same service in the same geographic community, or in a geographic community which is similar to that in which the service is rendered.

Customary Charge means the average charge for the service or supply in the geographic area concerned, as determined by the Trust Fund Administrator.

Customary Charge means the usual charge for providing a service or supply which does not exceed the general level of charges made by similar Providers in the area where the charge is incurred for a medical condition comparable in nature and severity to that being treated. The term “area” means a region large enough to obtain a representative cross section of similar Providers. Date of Disability means the initial date of Disability of the Member. Dentist means a doctor of dentistry duly qualified and licensed to practice dentistry in the area where the services are provided and is acting within the scope of that license.