Federal category
Service Availability
Requirements about whether, when, where, and under what conditions services, benefits, practitioners, items, or care settings must be available or covered.
Cascade
Source collection
Federal
Category group
Hospital Operations
Category
Service Availability
Grouped by instrument
Expand an instrument to inspect matching provisions
Instruments
13
Shown
50
Citation
42 CFR § 424.51
Payment to the provider.
This provision outlines the basic rules for Medicare payment to providers and specifies exceptions for outpatient hospital services.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
Medicare payment rules, Outpatient hospital payment
Citation
42 CFR § 424.52
Payment to a nonparticipating hospital.
Medicare pays a nonparticipating hospital for covered emergency inpatient and outpatient services or certain medical services under specific conditions.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
Medicare payment, Nonparticipating hospital
Citation
42 CFR § 424.53
Payment to the beneficiary.
This section specifies the circumstances under which Medicare makes payment directly to the beneficiary for services furnished by nonparticipating hospitals or suppliers.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
Medicare payment, Beneficiary payment
Citation
42 CFR § 424.58
Accreditation.
This regulation establishes the requirements for CMS-approved accrediting organizations for DMEPOS suppliers, including application procedures, ongoing oversight, complaint handling, and conflict of interest standards.
Group
Licensure Certification Accreditation
Category
Accreditation Approval
Domain
Facility Operations
Topics
Dmepos accreditation, Accrediting organization standards