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Federal regulations · Through 2026-08-25 · Newer source version available

42 CFR 424.108: Payment to a hospital.

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Where this section sits in the code
  1. Title 42—Public Health
  2. CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  3. SUBCHAPTER B—MEDICARE PROGRAM
  4. PART 424—CONDITIONS FOR MEDICARE PAYMENT
  5. Subpart G—Special Conditions: Emergency Services Furnished by a Nonparticipating Hospital

(a) Conditions for payment. Medicare pays the hospital for emergency services if the hospital—

(1) Has in effect a statement of election to claim payment for all covered emergency services furnished during a calendar year, in accordance with § 424.104;

(2) Claims payment in accordance with § 424.32; and

(3) Submits evidence requested by CMS to establish that the services meet the requirements of this subpart.

(b) Subsequent claims. If the hospital files subsequent claims because the initial claim did not include all the services furnished, those claims must include physicians' statements that—

(1) Contain sufficient information to clearly establish that, when the additional services were furnished, the emergency still existed; and

(2) Indicate when the emergency ended, which, for inpatient hospital services, is the earliest date on which the beneficiary could be safely discharged or transferred to a participating hospital or other institution.

Collected 2026-08-27T02:26:11Z. Source file · JSON

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