1. Medical practice business overhead costs that are not associated with the physician’s medical service directly provided to the patient (e.g., rent, office supplies, utilities). 2. In managed care programs, cost that cannot be associated directly with a certain activity, service, or product. Indirect costs are usually distributed among the plan’s services in proportion to each service’s share of direct costs.

Change or modification applied to payments under the prospective payment system (PPS) for hospitals that operate approved graduate medical education programs. For operating costs, the adjustment is based on the hospital’s ratio of interns and residents to the number of beds. For capital costs, the adjustment is based on the hospital’s ratio of interns and residents to average daily occupancy.

Association or connection between an individual and a health care provider in which the provider delivers care to the patient based on orders from another physician and the provider either gives services and supplies, reports diagnoses, or provides results directly to another provider who interacts with the patient. For example, a radiologist or a pathologist would be considered to have indirect treatment relationships with patients because they provide diagnostic services requested by other providers and furnish results to the patient through the direct treating physician.