424.126—Payment to the hospital.
(ii)
Reflects the hospital's intent to claim for all covered services furnished during a calendar year.
(3)
Submits evidence requested by CMS to establish that the services meet the requirements of this subpart.
(b) Amount of payment.
Payment is made (in accordance with § 413.74 of this chapter) on the basis of 100 percent of the hospital's customary charges, subject to the applicable deductible and coinsurance provisions set forth elsewhere in this chapter.