e-CFR data is current as of July 6, 2020
TITLE 42—Public Health
CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES SUBCHAPTER B—MEDICARE PROGRAM PART 409—HOSPITAL INSURANCE BENEFITS
Subpart A—HOSPITAL INSURANCE BENEFITS: GENERAL PROVISIONS
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| General description of benefits. |
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Subpart B—INPATIENT HOSPITAL SERVICES AND INPATIENT CRITICAL ACCESS HOSPITAL SERVICES
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| Nursing and related services, medical social services; use of hospital or CAH facilities. |
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| Supplies, appliances, and equipment. |
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| Services furnished by an intern or a resident-in-training. |
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| Other diagnostic or therapeutic services. |
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| Physical therapy, occupational therapy, and speech-language pathology services. |
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| Services related to kidney transplantations. |
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Subpart C—POSTHOSPITAL SNF CARE
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| Physical therapy, occupational therapy, and speech-language pathology services. |
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| Drugs, biologicals, supplies, appliances, and equipment. |
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| Transfer agreement hospital services. |
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| Other services generally provided by (or under arrangements made by) SNFs. |
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Subpart D—REQUIREMENTS FOR COVERAGE OF POSTHOSPITAL SNF CARE
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| Level of care requirement. |
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| Criteria for skilled services and the need for skilled services. |
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| Examples of skilled nursing and rehabilitation services. |
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| Criteria for “daily basis”. |
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| Criteria for “practical matter”. |
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| Effect of discharge from posthospital SNF care. |
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Subpart E—HOME HEALTH SERVICES UNDER HOSPITAL INSURANCE
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| Basis, purpose, and scope. |
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| Beneficiary qualifications for coverage of services. |
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| Plan of care requirements. |
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| Skilled services requirements. |
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| Dependent services requirements. |
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| Allowable administrative costs. |
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| Place of service requirements. |
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| Coinsurance for durable medical equipment (DME) and applicable disposable devices furnished as a home health service. |
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Subpart F—SCOPE OF HOSPITAL INSURANCE BENEFITS
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| General limitations on amount of benefits. |
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| Lifetime maximum on inpatient psychiatric care. |
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| Reduction of inpatient psychiatric benefit days available in the initial benefit period. |
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| Services that are counted toward allowable amounts. |
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| Revocation of election not to use lifetime reserve days. |
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| Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits. |
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Subpart G—HOSPITAL INSURANCE DEDUCTIBLES AND COINSURANCE
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| Inpatient deductible and coinsurance: General provisions. |
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| Inpatient hospital deductible. |
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| Inpatient hospital coinsurance. |
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| Skilled nursing facility (SNF) care coinsurance. |
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| Exemption of kidney donors from deductible and coinsurance requirements. |
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Subpart H—PAYMENT OF HOSPITAL INSURANCE BENEFITS
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