Title 42--Public Health

CHAPTER IV--HEALTH CARE FINANCING ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES

PART 409--HOSPITAL INSURANCE BENEFITS


TEXT PDF409.1 Statutory basis.
TEXT PDF409.2 Scope.
TEXT PDF409.3 Definitions.
TEXT PDF409.5 General description of benefits.
TEXT PDF409.10 Included services.
TEXT PDF409.11 Bed and board.
TEXT PDF409.12 Nursing and related services, medical social services; use of hospital or CAH facilities.
TEXT PDF409.13 Drugs and biologicals.
TEXT PDF409.14 Supplies, appliances, and equipment.
TEXT PDF409.15 Services furnished by an intern or a resident-in-training.
TEXT PDF409.16 Other diagnostic or therapeutic services.
TEXT PDF409.18 Services related to kidney transplantations.
TEXT PDF409.19 Services related to cardiac pacemakers and pacemaker leads.
TEXT PDF409.20 Coverage of services.
TEXT PDF409.21 Nursing care.
TEXT PDF409.22 Bed and board.
TEXT PDF409.23 Physical, occupational, and speech therapy.
TEXT PDF409.24 Medical social services.
TEXT PDF409.25 Drugs, biologicals, supplies, appliances, and equipment.
TEXT PDF409.26 Transfer agreement hospital services.
TEXT PDF409.27 Other services generally provided by (or under arrangements made by) SNFs.
TEXT PDF409.30 Basic requirements.
TEXT PDF409.31 Level of care requirement.
TEXT PDF409.32 Criteria for skilled services and the need for skilled services.
TEXT PDF409.33 Examples of skilled nursing and rehabilitation services.
TEXT PDF409.34 Criteria for ``daily basis''.
TEXT PDF409.35 Criteria for ``practical matter''.
TEXT PDF409.36 Effect of discharge from posthospital SNF care.
TEXT PDF409.40 Basis, purpose, and scope.
TEXT PDF409.41 Requirement for payment.
TEXT PDF409.42 Beneficiary qualifications for coverage of services.
TEXT PDF409.43 Plan of care requirements.
TEXT PDF409.44 Skilled services requirements.
TEXT PDF409.45 Dependent services requirements.
TEXT PDF409.46 Allowable administrative costs.
TEXT PDF409.47 Place of service requirements.
TEXT PDF409.48 Visits.
TEXT PDF409.49 Excluded services.
TEXT PDF409.50 Coinsurance for durable medical equipment (DME) furnished as a home health service.
TEXT PDF409.60 Benefit periods.
TEXT PDF409.61 General limitations on amount of benefits.
TEXT PDF409.62 Lifetime maximum on inpatient psychiatric care.
TEXT PDF409.63 Reduction of inpatient psychiatric benefit days available in the initial benefit period.
TEXT PDF409.64 Services that are counted toward allowable amounts.
TEXT PDF409.65 Lifetime reserve days.
TEXT PDF409.66 Revocation of election not to use lifetime reserve days.
TEXT PDF409.68 Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits.
TEXT PDF409.80 Inpatient deductible and coinsurance: General provisions.
TEXT PDF409.82 Inpatient hospital deductible.
TEXT PDF409.83 Inpatient hospital coinsurance.
TEXT PDF409.85 Skilled nursing facility (SNF) care coinsurance.
TEXT PDF409.87 Blood deductible.
TEXT PDF409.89 Exemption of kidney donors from deductible and coinsurance requirements.
TEXT PDF409.100 To whom payment is made.
TEXT PDF409.102 Amounts of payment.





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