GroundRules
Browse Federal regulations
Read the original sections, or search by topic.
- 42 CFR 408.90 · Termination of group billing arrangement.
- 42 CFR 408.92 · Change from group payment to deduction or individual payment.
- 42 CFR 408.100 · Termination of coverage for nonpayment of premiums.
- 42 CFR 408.102 · Reconsideration of termination.
- 42 CFR 408.104 · Reinstatement procedures.
- 42 CFR 408.110 · Collection of unpaid premiums.
- 42 CFR 408.112 · Refund of excess premiums after the enrollee dies.
- 42 CFR 408.200 · Statutory basis.
- 42 CFR 408.201 · Definitions.
- 42 CFR 408.202 · Conditions for participation.
- 42 CFR 408.205 · Application procedures.
- 42 CFR 408.207 · Billing and payment procedures.
- 42 CFR 408.210 · Termination of SMI premium surcharge agreement.
- 42 CFR 409.1 · Statutory basis.
- 42 CFR 409.2 · Scope.
- 42 CFR 409.3 · Definitions.
- 42 CFR 409.5 · General description of benefits.
- 42 CFR 409.10 · Included services.
- 42 CFR 409.11 · Bed and board.
- 42 CFR 409.12 · Nursing and related services, medical social services; use of hospital or CAH facilities.
- 42 CFR 409.13 · Drugs and biologicals.
- 42 CFR 409.14 · Supplies, appliances, and equipment.
- 42 CFR 409.15 · Services furnished by an intern or a resident-in-training.
- 42 CFR 409.16 · Other diagnostic or therapeutic services.
- 42 CFR 409.17 · Physical therapy, occupational therapy, and speech-language pathology services.
- 42 CFR 409.18 · Services related to kidney transplantations.
- 42 CFR 409.20 · Coverage of services.
- 42 CFR 409.21 · Nursing care.
- 42 CFR 409.22 · Bed and board.
- 42 CFR 409.23 · Physical therapy, occupational therapy, and speech-language pathology services.
- 42 CFR 409.24 · Medical social services.
- 42 CFR 409.25 · Drugs, biologicals, supplies, appliances, and equipment.
- 42 CFR 409.26 · Transfer agreement hospital services.
- 42 CFR 409.27 · Other services generally provided by (or under arrangements made by) SNFs.
- 42 CFR 409.30 · Basic requirements.
- 42 CFR 409.31 · Level of care requirement.
- 42 CFR 409.32 · Criteria for skilled services and the need for skilled services.
- 42 CFR 409.33 · Examples of skilled nursing and rehabilitation services.
- 42 CFR 409.34 · Criteria for “daily basis”.
- 42 CFR 409.35 · Criteria for “practical matter”.
- 42 CFR 409.36 · Effect of discharge from posthospital SNF care.
- 42 CFR 409.40 · Basis, purpose, and scope.
- 42 CFR 409.41 · Requirement for payment.
- 42 CFR 409.42 · Beneficiary qualifications for coverage of services.
- 42 CFR 409.43 · Plan of care requirements.
- 42 CFR 409.44 · Skilled services requirements.
- 42 CFR 409.45 · Dependent services requirements.
- 42 CFR 409.46 · Allowable administrative costs.
- 42 CFR 409.47 · Place of service requirements.
- 42 CFR 409.48 · Visits.
- 42 CFR 409.49 · Excluded services.
- 42 CFR 409.50 · Coinsurance for durable medical equipment (DME) and applicable disposable devices furnished as a home health service.
- 42 CFR 409.60 · Benefit periods.
- 42 CFR 409.61 · General limitations on amount of benefits.
- 42 CFR 409.62 · Lifetime maximum on inpatient psychiatric care.
- 42 CFR 409.63 · Reduction of inpatient psychiatric benefit days available in the initial benefit period.
- 42 CFR 409.64 · Services that are counted toward allowable amounts.
- 42 CFR 409.65 · Lifetime reserve days.
- 42 CFR 409.66 · Revocation of election not to use lifetime reserve days.
- 42 CFR 409.68 · Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits.
- 42 CFR 409.80 · Inpatient deductible and coinsurance: General provisions.
- 42 CFR 409.82 · Inpatient hospital deductible.
- 42 CFR 409.83 · Inpatient hospital coinsurance.
- 42 CFR 409.85 · Skilled nursing facility (SNF) care coinsurance.
- 42 CFR 409.87 · Blood deductible.
- 42 CFR 409.89 · Exemption of kidney donors from deductible and coinsurance requirements.
- 42 CFR 409.100 · To whom payment is made.
- 42 CFR 409.102 · Amounts of payment.
- 42 CFR 410.1 · Basis and scope.
- 42 CFR 410.2 · Definitions.
- 42 CFR 410.3 · Scope of benefits.
- 42 CFR 410.5 · Other applicable rules.
- 42 CFR 410.10 · Medical and other health services: Included services.
- 42 CFR 410.12 · Medical and other health services: Basic conditions and limitations.
- 42 CFR 410.14 · Special requirements for services furnished outside the United States.
- 42 CFR 410.15 · Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage.
- 42 CFR 410.16 · Initial preventive physical examination: Conditions for and limitations on coverage.
- 42 CFR 410.17 · Cardiovascular disease screening tests.
- 42 CFR 410.18 · Diabetes screening tests.
- 42 CFR 410.19 · Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.
- 42 CFR 410.20 · Physicians' services.
- 42 CFR 410.21 · Limitations on services of a chiropractor.
- 42 CFR 410.22 · Limitations on services of an optometrist.
- 42 CFR 410.23 · Screening for glaucoma: Conditions for and limitations on coverage.
- 42 CFR 410.24 · Limitations on services of a doctor of dental surgery or dental medicine.
- 42 CFR 410.25 · Limitations on services of a podiatrist.
- 42 CFR 410.26 · Services and supplies incident to a physician's professional services: Conditions.
- 42 CFR 410.27 · Therapeutic outpatient hospital or CAH services and supplies incident to a physician's or nonphysician practitioner's service: Conditions.
- 42 CFR 410.28 · Hospital or CAH diagnostic services furnished to outpatients: Conditions.
- 42 CFR 410.29 · Limitations on drugs and biologicals.
- 42 CFR 410.30 · Prescription drugs used in immunosuppressive therapy.
- 42 CFR 410.31 · Bone mass measurement: Conditions for coverage and frequency standards.
- 42 CFR 410.32 · Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.
- 42 CFR 410.33 · Independent diagnostic testing facility.
- 42 CFR 410.34 · Mammography services: Conditions for and limitations on coverage.
- 42 CFR 410.35 · X-ray therapy and other radiation therapy services: Scope.
- 42 CFR 410.36 · Medical supplies, appliances, and devices: Scope.
- 42 CFR 410.37 · Colorectal cancer screening tests: Conditions for and limitations on coverage.
- 42 CFR 410.38 · Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS): Scope and conditions.
- 42 CFR 410.39 · Prostate cancer screening tests: Conditions for and limitations on coverage.