---
kind: "section"
citation: "42 C.F.R. § 414.48"
title: "42"
number: "414.48"
heading: "Limits on actual charges of nonparticipating suppliers."
url: "https://uscodex.org/cfr/42/414.48"
---

# §414.48. Limits on actual charges of nonparticipating suppliers.

- (a) **General rule.** A supplier, as defined in [§ 400.202](/cfr/42/400.202.md) of this chapter, who is nonparticipating and does not accept assignment may charge a beneficiary an amount up to the limiting charge described in [paragraph (b)](#b) of this section.
- (b) **Specific limits.** For items or services paid under the physician fee schedule, the limiting charge is 115 percent of the fee schedule amount for nonparticipating suppliers. For items or services CMS excludes from payment under the physician fee schedule (in accordance with section 1848 (j)(3) of the Act), the limiting charge is 115 percent of 95 percent of the payment basis applicable to participating suppliers as calculated in [§ 414.20(b)](/cfr/42/414.20.md?p=b).

## Notes

### Amendments

[58 FR 63687, Dec. 2, 1993, as amended at 62 FR 59102, Oct. 31, 1997]

### Source

Source: 56 FR 59624, Nov. 25, 1991; 57 FR 42492, Sept. 15, 1992, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302, 1395hh, and 1395rr(b)(l).

### Source

Source: 55 FR 23441, June 8, 1990, unless otherwise noted.

### Amendments

[58 FR 63687, Dec. 2, 1993, as amended at 62 FR 59102, Oct. 31, 1997]