42 CFR § 447.271 - Upper limits based on customary charges.

---
identifier: "/us/cfr/t42/s447.271"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 447.271 - Upper limits based on customary charges."
title_number: 42
title_name: "Public Health"
section_number: "447.271"
section_name: "Upper limits based on customary charges."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "C"
subchapter_name: "MEDICAL ASSISTANCE PROGRAMS"
part_number: "447"
part_name: "PAYMENTS FOR SERVICES"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302, and 1396r-8, and Pub. L. 111-148."
regulatory_source: "43 FR 45253, Sept. 29, 1978, unless otherwise noted."
cfr_part: "447"
---


# 447.271 Upper limits based on customary charges.

(a) Except as provided in paragraph (b) of this section, the agency may not pay a provider more for inpatient hospital services under Medicaid than the provider's customary charges to the general public for the services.

(b) The agency may pay a public provider that provides services free or at a nominal charge at the same rate that would be used if the provider charges were equal to or greater than its costs.

[75 FR 73975, Nov. 30, 2010]