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