OJA Cost Reimbursement Cost Principles 22206 doc 2025

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Under the reasonable cost reimbursement methodology, payment for both Part A and Part B services furnished by most providers was based on the lesser of the reasonable cost of the services, as determined under section 1861(v) of the Act, or the providers customary charges for the services.
(1) Reasonableness. (2) Allocability. (3) Standards promulgated by the CAS Board, if applicable, otherwise, generally accepted accounting principles and practices appropriate to the circumstances.
Reasonable Costs A cost is reasonable if, in its nature and amount, it does not exceed that which would be incurred by a prudent person in the conduct of competitive business.
Medicare Reasonable Cost: Reasonable cost includes all necessary and proper costs incurred in rendering the services, subject to principles relating to specific items of revenue and cost [PRM-I, Chapter 21, Section 2100].
Reasonable cost includes all necessary and proper expenses incurred in furnishing services, such as adminis- trative costs, maintenance costs, and premium payments for employee health and pension plans.
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