GroundRules
42 CFR 424.126: Payment to the hospital.
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
(a) Conditions for payment. Medicare pays the hospital if it—
(1) Has in effect an election that—
(i) Meets the requirements set forth in § 424.104; and
(ii) Reflects the hospital's intent to claim for all covered services furnished during a calendar year.
(2) Claims payment in accordance with §§ 424.32 and 413.74 of this chapter; and
(3) Submits evidence requested by CMS to establish that the services meet the requirements of this subpart.
(b) Amount of payment. Payment is made (in accordance with § 413.74 of this chapter) on the basis of 100 percent of the hospital's customary charges, subject to the applicable deductible and coinsurance provisions set forth elsewhere in this chapter.
Collected 2026-08-27T02:26:11Z. Source file · JSON