---
kind: "section"
citation: "42 C.F.R. § 415.55"
title: "42"
number: "415.55"
heading: "General payment rules."
url: "https://uscodex.org/cfr/42/415.55"
---

# §415.55. General payment rules.

- (a) **Allowable costs.** Except as specified otherwise in [§§ 413.102](/cfr/42/413.102.md) of this chapter (concerning compensation of owners), 415.60 (concerning allocation of physician compensation costs), and 415.162 (concerning payment for physician services furnished to beneficiaries in teaching hospitals), costs a provider incurs for services of physicians are allowable only if the following conditions are met:
  - (1) The services do not meet the conditions in [§ 415.102(a)](/cfr/42/415.102.md?p=a) regarding fee schedule payment for services of physicians to a beneficiary in a provider.
  - (2) The services include a surgeon's supervision of services of a qualified anesthetist, but do not include physician availability services, except for reasonable availability services furnished for emergency rooms and the services of standby surgical team physicians.
  - (3) The provider has incurred a cost for salary or other compensation it furnished the physician for the services.
  - (4) The costs incurred by the provider for the services meet the requirements in [§ 413.9](/cfr/42/413.9.md) of this chapter regarding costs related to patient care.
  - (5) The costs do not include supervision of interns and residents unless the provider elects reasonable cost payment as specified in [§ 415.160](/cfr/42/415.160.md), or any other costs incurred in connection with an approved GME program that are payable under [§§ 413.75 through 413.83](/cfr/42/413.75..413.83.md) of this chapter.
- (b) **Allocation of allowable costs.** The provider must follow the rules in [§ 415.60](/cfr/42/415.60.md) regarding allocation of physician compensation costs to determine its costs of services.
- (c) **Limits on allowable costs.** The intermediary must apply the limits on compensation set forth in [§ 415.70](/cfr/42/415.70.md) to determine its payments to a provider for the costs of services.

## Notes

### Amendments

[60 FR 63178, Dec. 8, 1995, as amended at 70 FR 47490, Aug. 12, 2005]

### Authority

Authority: 42 U.S.C. 1302 and 1395hh.

### Source

Source: 60 FR 63178, Dec. 8, 1995, unless otherwise noted.

### Amendments

[60 FR 63178, Dec. 8, 1995, as amended at 70 FR 47490, Aug. 12, 2005]