Provider of Services (Health Care) Law and Legal Definition

A provider of services in the context of health care refers to an entity such as a hospital, critical access hospital, skilled nursing facility, comprehensive outpatient rehabilitation facility, home health agency, or a hospice program that provides medical and other health care services to the beneficiaries enrolled in the insurance program. When a provider of services provides services which are furnished by a clinic, rehabilitation agency, or a public health agency, they are considered as outpatient physical therapy services. Pursuant to 42 U.S.C.S. § 1395f(b)(1), the amount paid to any provider of services with respect to services for which payment may be made shall be the lesser of (a) the reasonable cost of such services, or (b) the customary charges with respect to such services.