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Code of Federal Regulations (Last Updated: April 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 409 - Hospital Insurance Benefits |
| 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. |
| § 409.19 - Services related to cardiac pacemakers and pacemaker leads. |
| 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. |