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42 C.F.R. PART 409--HOSPITAL INSURANCE BENEFITS

TITLE 42--Public Health

CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

SUBCHAPTER B--MEDICARE PROGRAM

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.

�409.18

Services related to kidney transplantations.

Subpart C--POSTHOSPITAL SNF CARE

�409.20

Coverage of services.

�409.21

Nursing care.

�409.22

Bed and board.

�409.23

Physical, occupational, and speech therapy.

�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) 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.