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Code of Federal Regulations (Last Updated: July 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 424 - Conditions for Medicare Payment |
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Subpart H - Special Conditions: Services Furnished in a Foreign Country |
§ 424.124 - Conditions for payment for physician services and ambulance services.
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§ 424.124 Conditions for payment for physician services and ambulance services.
(a) Basic rules. Medicare Part B pays for physician and ambulance services if -
(1) They are furnished -
(i) To an individual who is entitled to Part B benefits; and
(ii) In connection with covered inpatient hospital services; and
(2) They meet the conditions set forth in paragraphs (b) and (c) of this section.
(b) Physician services.
(1) The physician services are services covered under Medicare Part B and are furnished -
(i) In the hospital, during a period of covered inpatient services; or
(ii) Outside the hospital, on the day of admission and for the same condition that required inpatient admission; and
(2) The physician is legally authorized to practice in the country where he or she furnishes the services.
(c) Ambulance services. The ambulance services are -
(1) Necessary because the use of other means of transportation is contraindicated by the beneficiary's condition; and
(2) Furnished by an ambulance that meets the definition in § 410.41 of this chapter.
[53 FR 6646, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988; 64 FR 3649, Jan. 25, 1999]