Title 42--Public Health
CHAPTER IV--HEALTH CARE FINANCING ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES
PART 409--HOSPITAL INSURANCE BENEFITS
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| 409.1 |
Statutory basis. |
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| 409.2 |
Scope. |
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| 409.3 |
Definitions. |
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| 409.5 |
General description of benefits. |
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| 409.10 |
Included services. |
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| 409.11 |
Bed and board. |
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| 409.12 |
Nursing and related services, medical social services; use of hospital or CAH facilities. |
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| 409.13 |
Drugs and biologicals. |
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| 409.14 |
Supplies, appliances, and equipment. |
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| 409.15 |
Services furnished by an intern or a resident-in-training. |
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| 409.16 |
Other diagnostic or therapeutic services. |
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| 409.18 |
Services related to kidney transplantations. |
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| 409.19 |
Services related to cardiac pacemakers and pacemaker leads. |
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| 409.20 |
Coverage of services.
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| 409.21 |
Nursing care. |
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| 409.22 |
Bed and board. |
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| 409.23 |
Physical, occupational, and speech therapy. |
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| 409.24 |
Medical social services. |
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| 409.25 |
Drugs, biologicals, supplies, appliances, and equipment. |
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| 409.26 |
Transfer agreement hospital services. |
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| 409.27 |
Other services generally provided by (or under arrangements made by) SNFs.
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| 409.30 |
Basic requirements.
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| 409.31 |
Level of care requirement. |
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| 409.32 |
Criteria for skilled services and the need for skilled services. |
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| 409.33 |
Examples of skilled nursing and rehabilitation services.
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| 409.34 |
Criteria for ``daily basis''. |
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| 409.35 |
Criteria for ``practical matter''. |
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| 409.36 |
Effect of discharge from posthospital SNF care. |
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| 409.40 |
Basis, purpose, and scope. |
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| 409.41 |
Requirement for payment. |
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| 409.42 |
Beneficiary qualifications for coverage of services. |
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| 409.43 |
Plan of care requirements. |
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| 409.44 |
Skilled services requirements. |
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| 409.45 |
Dependent services requirements. |
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| 409.46 |
Allowable administrative costs. |
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| 409.47 |
Place of service requirements. |
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| 409.48 |
Visits. |
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| 409.49 |
Excluded services. |
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| 409.50 |
Coinsurance for durable medical equipment (DME) furnished as a home health service. |
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| 409.60 |
Benefit periods. |
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| 409.61 |
General limitations on amount of benefits. |
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| 409.62 |
Lifetime maximum on inpatient psychiatric care. |
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| 409.63 |
Reduction of inpatient psychiatric benefit days available in the initial benefit period. |
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| 409.64 |
Services that are counted toward allowable amounts. |
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| 409.65 |
Lifetime reserve days. |
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| 409.66 |
Revocation of election not to use lifetime reserve days. |
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| 409.68 |
Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits. |
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| 409.80 |
Inpatient deductible and coinsurance: General provisions. |
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| 409.82 |
Inpatient hospital deductible. |
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| 409.83 |
Inpatient hospital coinsurance. |
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| 409.85 |
Skilled nursing facility (SNF) care coinsurance. |
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| 409.87 |
Blood deductible. |
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| 409.89 |
Exemption of kidney donors from deductible and coinsurance requirements. |
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| 409.100 |
To whom payment is made. |
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| 409.102 |
Amounts of payment. |