Code of Federal Regulations (Last Updated: October 10, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter B - Medicare Program |
Part 424 - Conditions for Medicare Payment |
Subpart G - Special Conditions: Emergency Services Furnished by a Nonparticipating Hospital |
§ 424.109 - Payment to the beneficiary.
Latest version.
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§ 424.109 Payment to the beneficiary.
Medicare pays the beneficiary for emergency services if the following conditions are met:
(a) The hospital does not have in effect an election to claim payment.
(b) The beneficiary, or someone on his or her behalf, submits -
(1) A claim that meets the requirements of § 424.32;
(2) An itemized hospital bill; and
(3) Evidence requested by CMS to establish that the services meet the requirements of this subpart.