GroundRules
42 CFR 424.122: Conditions for payment for emergency inpatient hospital services.
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 H—Special Conditions: Services Furnished in a Foreign Country
Medicare Part A pays for emergency inpatient hospital services furnished by a foreign hospital if the following conditions are met:
(a) At the time of the emergency that required the inpatient hospital services, the beneficiary was—
(1) In the United States; or
(2) In Canada traveling between Alaska and another State without unreasonable delay and by the most direct route.
(b) The foreign hospital was closer to, or more accessible from, the site of the emergency than the nearest United States hospital equipped to deal with, and available to treat, the individual's illness or injury.
(c) The conditions for payment for emergency services set forth in § 424.103 are met.
(d) The hospital is a hospital as defined in § 424.101, and is licensed, or approved as meeting the conditions for licensing, by the appropriate agency of the country in which it is located.
(e) The determination of whether the hospital was more accessible is made in accordance with § 424.106.
Collected 2026-08-27T02:26:11Z. Source file · JSON