42 CFR Part 409
PART 409—HOSPITAL INSURANCE BENEFITS
- PART 409—HOSPITAL INSURANCE BENEFITS
- Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services › Subchapter B—Medicare Program
- Subpart A—Hospital Insurance Benefits: General Provisions
- § 409.1 Statutory basis.
- § 409.2 Scope.
- § 409.3 Definitions.
- § 409.5 General description of benefits.
- Subpart B—Inpatient Hospital Services and Inpatient Critical Access Hospital Services
- § 409.10 Included services.
- § 409.11 Bed and board.
- § 409.12 Nursing and related services, medical social services; use of hospital or CAH facilities.
- § 409.13 Drugs and biologicals.
- § 409.14 Supplies, appliances, and equipment.
- § 409.15 Services furnished by an intern or a resident-in-training.
- § 409.16 Other diagnostic or therapeutic services.
- § 409.17 Physical therapy, occupational therapy, and speech-language pathology services.
- § 409.18 Services related to kidney transplantations.
- Subpart C—Posthospital SNF Care
- § 409.20 Coverage of services.
- § 409.21 Nursing care.
- § 409.22 Bed and board.
- § 409.23 Physical therapy, occupational therapy, and speech-language pathology services.
- § 409.24 Medical social services.
- § 409.25 Drugs, biologicals, supplies, appliances, and equipment.
- § 409.26 Transfer agreement hospital services.
- § 409.27 Other services generally provided by (or under arrangements made by) SNFs.
- Subpart D—Requirements for Coverage of Posthospital SNF Care
- § 409.30 Basic requirements.
- § 409.31 Level of care requirement.
- § 409.32 Criteria for skilled services and the need for skilled services.
- § 409.33 Examples of skilled nursing and rehabilitation services.
- § 409.34 Criteria for “daily basis”.
- § 409.35 Criteria for “practical matter”.
- § 409.36 Effect of discharge from posthospital SNF care.
- Subpart E—Home Health Services Under Hospital Insurance
- § 409.40 Basis, purpose, and scope.
- § 409.41 Requirement for payment.
- § 409.42 Beneficiary qualifications for coverage of services.
- § 409.43 Plan of care requirements.
- § 409.44 Skilled services requirements.
- § 409.45 Dependent services requirements.
- § 409.46 Allowable administrative costs.
- § 409.47 Place of service requirements.
- § 409.48 Visits.
- § 409.49 Excluded services.
- § 409.50 Coinsurance for durable medical equipment (DME) and applicable disposable devices furnished as a home health service.
- Subpart F—Scope of Hospital Insurance Benefits
- § 409.60 Benefit periods.
- § 409.61 General limitations on amount of benefits.
- § 409.62 Lifetime maximum on inpatient psychiatric care.
- § 409.63 Reduction of inpatient psychiatric benefit days available in the initial benefit period.
- § 409.64 Services that are counted toward allowable amounts.
- § 409.65 Lifetime reserve days.
- § 409.66 Revocation of election not to use lifetime reserve days.
- § 409.68 Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits.
- Subpart G—Hospital Insurance Deductibles and Coinsurance
- § 409.80 Inpatient deductible and coinsurance: General provisions.
- § 409.82 Inpatient hospital deductible.
- § 409.83 Inpatient hospital coinsurance.
- § 409.85 Skilled nursing facility (SNF) care coinsurance.
- § 409.87 Blood deductible.
- § 409.89 Exemption of kidney donors from deductible and coinsurance requirements.
- Subpart H—Payment of Hospital Insurance Benefits
- § 409.100 To whom payment is made.
- § 409.102 Amounts of payment.
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