42 CFR 424.124 - Conditions for payment for physician services and ambulance services.

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There are 5 Updates appearing in the Federal Register for 42 CFR Part 424. View below or at eCFR (GPOAccess)
§ 424.124 Conditions for payment for physician services and ambulance services.

(a)Basic rules.Medicare Part B pays for physician and ambulance services if -

(1) They are furnished -

(i) To an individual who is entitled to Part B benefits; and

(ii) In connection with covered inpatienthospital services; and

(2) They meet the conditions set forth in paragraphs (b) and (c) of this section.

(b)Physician services.

(1) The physician services are services covered under Medicare Part B and are furnished -

(i) In the hospital, during a period of covered inpatient services; or

(ii) Outside the hospital, on the day of admission and for the same condition that required inpatient admission; and

(2) The physician is legally authorized to practice in the country where he or she furnishes the services.

(c)Ambulance services. The ambulance services are -

(1) Necessary because the use of other means of transportation is contraindicated by the beneficiary's condition; and

(2) Furnished by an ambulance that meets the definition in § 410.41 of this chapter.

[53 FR 6646, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988; 64 FR 3649, Jan. 25, 1999]

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United States Code

Title 42 published on 2015-11-28

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

  • 2017-01-12; vol. 82 # 8 - Thursday, January 12, 2017
    1. 82 FR 3678 - Medicare Program; Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom-Fabricated Orthotics
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      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Proposed rule.
      To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on March 13, 2017.
      42 CFR Part 424
The section you are viewing is cited by the following CFR sections.

Title 42 published on 2015-11-28.

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.

  • 2016-12-29; vol. 81 # 250 - Thursday, December 29, 2016
    1. 81 FR 95890 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements; Corrections
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      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule; correction.
      This correcting document is effective January 1, 2017.
      42 CFR Parts 405, 410, 411, 414, 417, 422, 423, 424, 425, and 460