42 CFR 424.127 - Payment to the beneficiary.

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§ 424.127 Payment to the beneficiary.
(a) Conditions for payment of inpatient hospital services. Medicare pays the beneficiary if—
(1) The hospital does not have in effect an election to claim payment; and
(2) The beneficiary, or someone on his or her behalf, submits—
(i) A claim in accordance with § 424.32;
(ii) An itemized hospital bill; and
(iii) Evidence requested by CMS to establish that the services meet the requirements of this subpart.
(b) Amount payable for inpatient hospital services. The amount payable to the beneficiary is determined in accordance with § 424.109(b).
(c) Conditions for payment for Part B services. Medicare pays the beneficiary for physicians' services and ambulance services as specified in § 424.121, if an itemized bill for the services is submitted by the beneficiary or someone on his or her behalf and the conditions of § 424.126(a) (2) and (3) are met.
(d) The amount payable to the beneficiary is determined in accordance with § 410.152 of this chapter.

Title 42 published on 2014-10-01

The following are only the Rules published in the Federal Register after the published date of Title 42.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2014-12-05; vol. 79 # 234 - Friday, December 5, 2014
    1. 79 FR 72500 - Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule.
      These regulations are effective on February 3, 2015.
      42 CFR Parts 405, 424, and 498

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United States Code

Title 42 published on 2014-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR 424 after this date.

  • 2014-12-05; vol. 79 # 234 - Friday, December 5, 2014
    1. 79 FR 72500 - Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule.
      These regulations are effective on February 3, 2015.
      42 CFR Parts 405, 424, and 498