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- 42 CFR 413.174 · Prospective rates for hospital-based and independent ESRD facilities.
- 42 CFR 413.176 · Amount of payments.
- 42 CFR 413.177 · Quality incentive program payment.
- 42 CFR 413.178 · ESRD quality incentive program.
- 42 CFR 413.180 · Procedures for requesting exceptions to payment rates.
- 42 CFR 413.182 · Criteria for approval of exception requests.
- 42 CFR 413.184 · Payment exception: Pediatric patient mix.
- 42 CFR 413.186 · Payment exception: Self-dialysis training costs in pediatric facilities.
- 42 CFR 413.194 · Appeals.
- 42 CFR 413.195 · Limitation on Review.
- 42 CFR 413.196 · Notification of changes in rate-setting methodologies and payment rates.
- 42 CFR 413.198 · Recordkeeping and cost reporting requirements for outpatient maintenance dialysis.
- 42 CFR 413.200 · [Reserved]
- 42 CFR 413.202 · Organ procurement organization (OPO) cost for kidneys sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
- 42 CFR 413.203 · Transplant center costs for organs sent to foreign countries or transplanted in patients other than Medicare beneficiaries.
- 42 CFR 413.210 · Conditions for payment under the end-stage renal disease (ESRD) prospective payment system.
- 42 CFR 413.215 · Basis of payment.
- 42 CFR 413.217 · Items and services included in the ESRD prospective payment system.
- 42 CFR 413.220 · Methodology for calculating the per-treatment base rate under the ESRD prospective payment system effective January 1, 2011.
- 42 CFR 413.230 · Determining the per treatment payment amount.
- 42 CFR 413.231 · Adjustment for wages.
- 42 CFR 413.232 · Low-volume adjustment.
- 42 CFR 413.233 · Additional facility-level adjustments.
- 42 CFR 413.234 · Drug designation process.
- 42 CFR 413.235 · Patient-level adjustments.
- 42 CFR 413.236 · Transitional add-on payment adjustment for new and innovative equipment and supplies.
- 42 CFR 413.237 · Outliers.
- 42 CFR 413.239 · Transition period.
- 42 CFR 413.241 · Pharmacy arrangements.
- 42 CFR 413.300 · Basis and scope.
- 42 CFR 413.302 · Definitions.
- 42 CFR 413.304 · Eligibility for prospectively determined payment rates.
- 42 CFR 413.308 · Rules governing election of prospectively determined payment rates.
- 42 CFR 413.310 · Basis of payment.
- 42 CFR 413.312 · Methodology for calculating rates.
- 42 CFR 413.314 · Determining payment amounts: Routine per diem rate.
- 42 CFR 413.316 · Determining payment amounts: Ancillary services.
- 42 CFR 413.320 · Publication of prospectively determined payment rates or amounts.
- 42 CFR 413.321 · Simplified cost report for SNFs.
- 42 CFR 413.330 · Basis and scope.
- 42 CFR 413.333 · Definitions.
- 42 CFR 413.335 · Basis of payment.
- 42 CFR 413.337 · Methodology for calculating the prospective payment rates.
- 42 CFR 413.338 · Skilled nursing facility value-based purchasing program.
- 42 CFR 413.340 · Transition period.
- 42 CFR 413.343 · Resident assessment data.
- 42 CFR 413.345 · Publication of Federal prospective payment rates.
- 42 CFR 413.348 · Limitation on review.
- 42 CFR 413.350 · Periodic interim payments for skilled nursing facilities receiving payment under the skilled nursing facility prospective payment system for Part A services.
- 42 CFR 413.355 · Additional payment: QIO reimbursement for cost of sending records electronically or by photocopy and mailing.
- 42 CFR 413.360 · Requirements under the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP).
- 42 CFR 413.370 · Scope.
- 42 CFR 413.371 · Definition.
- 42 CFR 413.372 · AKI dialysis payment rate.
- 42 CFR 413.373 · Other adjustments to the AKI dialysis payment rate.
- 42 CFR 413.374 · Renal dialysis services included in the AKI dialysis payment rate.
- 42 CFR 413.375 · Notification of changes in rate-setting methodologies and payment rates.
- 42 CFR 413.400 · Definitions.
- 42 CFR 413.402 · Organ acquisition costs.
- 42 CFR 413.404 · Standard acquisition charge.
- 42 CFR 413.406 · Acquisition of pancreata for islet cell transplant.
- 42 CFR 413.408 · [Reserved]
- 42 CFR 413.410 · [Reserved]
- 42 CFR 413.412 · Intent to transplant, intent for research, counting en bloc, and unusable organs.
- 42 CFR 413.414 · Medicare secondary payer and organ acquisition costs.
- 42 CFR 413.416 · Organ acquisition charges for kidney-paired exchanges.
- 42 CFR 413.418 · Amounts billed to organ procurement organizations for hospital services provided to deceased donors and included as organ acquisition costs.
- 42 CFR 413.420 · Payment to independent organ procurement organizations (IOPOs) and histocompatibility laboratories (HCLs) for organ acquisition costs.
- 42 CFR 414.1 · Basis and scope.
- 42 CFR 414.2 · Definitions.
- 42 CFR 414.4 · Fee schedule areas.
- 42 CFR 414.5 · Hospital services paid under Medicare Part B when a Part A hospital inpatient claim is denied because the inpatient admission was not reasonable and necessary, but hospital outpatient services would have been reasonable and necessary in treating the beneficiary.
- 42 CFR 414.20 · Formula for computing fee schedule amounts.
- 42 CFR 414.21 · Medicare payment basis.
- 42 CFR 414.22 · Relative value units (RVUs).
- 42 CFR 414.24 · Publication of RVUs and direct PE inputs.
- 42 CFR 414.26 · Determining the GAF.
- 42 CFR 414.28 · Conversion factors.
- 42 CFR 414.30 · Conversion factor update.
- 42 CFR 414.34 · Payment for services and supplies incident to a physician's service.
- 42 CFR 414.36 · Payment for drugs incident to a physician's service.
- 42 CFR 414.39 · Special rules for payment of care plan oversight.
- 42 CFR 414.40 · Coding and ancillary policies.
- 42 CFR 414.42 · Adjustment for first 4 years of practice.
- 42 CFR 414.44 · Transition rules.
- 42 CFR 414.46 · Additional rules for payment of anesthesia services.
- 42 CFR 414.48 · Limits on actual charges of nonparticipating suppliers.
- 42 CFR 414.50 · Physician or other supplier billing for diagnostic tests performed or interpreted by a physician who does not share a practice with the billing physician or other supplier.
- 42 CFR 414.52 · Payment for physician assistants' services.
- 42 CFR 414.53 · Fee schedule for clinical social worker, marriage and family therapist, and mental health counselor services.
- 42 CFR 414.54 · Payment for certified nurse-midwives' services.
- 42 CFR 414.56 · Payment for nurse practitioners' and clinical nurse specialists' services.
- 42 CFR 414.58 · Payment of charges for physician services to patients in providers.
- 42 CFR 414.60 · Payment for the services of CRNAs.
- 42 CFR 414.61 · Payment for anesthesia services furnished by a teaching CRNA.
- 42 CFR 414.62 · Fee schedule for clinical psychologist services.
- 42 CFR 414.63 · Payment for outpatient diabetes self-management training.
- 42 CFR 414.64 · Payment for medical nutrition therapy.
- 42 CFR 414.65 · Payment for telehealth services.
- 42 CFR 414.66 · Incentive payments for physician scarcity areas.