42 C.F.R. § 419.21 Hospital outpatient services subject to the outpatient prospective payment system.
Title 42 - Public Health
Except for services described in §419.22, effective for services furnished on or after July 1, 2000, payment is made under the hospital outpatient prospective payment system for the following: (a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part. (b) Services designated by the Secretary that are covered under Medicare Part B when furnished to hospital inpatients who are either not entitled to benefits under Part A or who have exhausted their Part A benefits but are entitled to benefits under Part B of the program. (c) Partial hospitalization services furnished by community mental health centers (CMHCs). (d) The following medical and other health services furnished by a comprehensive outpatient rehabilitation facility (CORF) when they are provided outside the patient's plan (of care); or by a home health agency (HHA) to patients who are not under an HHA plan or treatment; or by a hospice program furnishing services to patients outside the hospice benefit: (1) Antigens. (2) Splints and casts. (3) Hepatitis B vaccine. (e) Effective January 1, 2005, an initial preventive physical examination, as defined in §410.16 of this chapter, if the examination is performed no later than 6 months after the individual's initial Part B coverage date that begins on or after January 1, 2005. [65 FR 18542, Apr. 7, 2000, as amended at 67 FR 66813, Nov. 1, 2002; 69 FR 65863, Nov. 15, 2004]
Title 42: Public Health
PART 419—PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES
Subpart B—Categories of Hospitals and Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System
§ 419.21 Hospital outpatient services subject to the outpatient prospective payment system.
