GroundRules
42 CFR 460.96: Excluded 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 E—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
- PART 460—PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
- Subpart F—PACE Services
The following services are excluded from coverage under PACE:
(a) Cosmetic surgery, which does not include surgery that is required for improved functioning of a malformed part of the body resulting from an accidental injury or for reconstruction following mastectomy.
(b) Experimental medical, surgical, or other health procedures.
(c) Services furnished outside of the United States, except as follows:
(1) In accordance with § 424.122 and § 424.124 of this chapter.
(2) As permitted under the State's approved Medicaid plan.
Collected 2026-08-27T02:26:11Z. Source file · JSON