GroundRules
42 CFR 424.109: Payment to the beneficiary.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER B—MEDICARE PROGRAM
- PART 424—CONDITIONS FOR MEDICARE PAYMENT
- Subpart G—Special Conditions: Emergency Services Furnished by a Nonparticipating Hospital
Medicare pays the beneficiary for emergency services if the following conditions are met:
(a) The hospital does not have in effect an election to claim payment.
(b) The beneficiary, or someone on his or her behalf, submits—
(1) A claim that meets the requirements of § 424.32;
(2) An itemized hospital bill; and
(3) Evidence requested by CMS to establish that the services meet the requirements of this subpart.
Collected 2026-08-27T02:26:11Z. Source file · JSON