Usual, Customary, And Reasonable Charge

What Does Usual, Customary, And Reasonable Charge Mean?

Usual, customary, and reasonable charges (UCR) refer to the fees that healthcare providers charge for a specific service in a given area.

Health insurance companies determine their coverage based on these amounts.

Insuranceopedia Explains Usual, Customary, And Reasonable Charge

Healthcare facilities within an insurance company’s preferred provider network typically charge the usual, customary, and reasonable (UCR) rates for their services.

If a healthcare facility outside the network charges more than the UCR, the insured individual is usually responsible for paying the amount exceeding the UCR out of pocket.