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42 C.F.R. PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES

TITLE 42--Public Health

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

SUBCHAPTER B--MEDICARE PROGRAM

PART 419--PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES

Subpart A--GENERAL PROVISIONS

�419.1

Basis and scope.

�419.2

Basis of payment.

Subpart B--CATEGORIES OF HOSPITALS AND SERVICES SUBJECT TO AND EXCLUDED FROM THE HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT SYSTEM

�419.20

Hospitals subject to the hospital outpatient prospective payment system.

�419.21

Hospital outpatient services subject to the outpatient prospective payment system.

�419.22

Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system.

Subpart C--BASIC METHODOLOGY FOR DETERMINING PROSPECTIVE PAYMENT RATES FOR HOSPITAL OUTPATIENT SERVICES

�419.30

Base expenditure target for calendar year 1999.

�419.31

Ambulatory payment classification (APC) system and payment weights.

�419.32

Calculation of prospective payment rates for hospital outpatient services.

Subpart D--PAYMENTS TO HOSPITALS

�419.40

Payment concepts.

�419.41

Calculation of national beneficiary copayment amounts and national Medicare program payment amounts.

�419.42

Hospital election to reduce coinsurance.

�419.43

Adjustments to national program payment and beneficiary copayment amounts.

�419.44

Payment reductions for surgical procedures.

Subpart E--UPDATES

�419.50

Annual review.

Subpart F--LIMITATIONS ON REVIEW

�419.60

Limitations on administrative and judicial review.

Subpart G--TRANSITIONAL PASS-THROUGH PAYMENTS

�419.62

Transitional pass-through payments: General rules.

�419.64

Transitional pass-through payments: Drugs and biologicals.

�419.66

Transitional pass-through payments: Medical devices.

Subpart H--TRANSITIONAL CORRIDORS

�419.70

Transitional adjustments to limit decline in payments.