e-CFR data is current as of February 22, 2021
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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