{"data":{"id":"us/42-cfr-405.920","jurisdiction":"us","citation":"42 CFR 405.920","heading":"Initial determinations.","body":"After a claim is filed with the appropriate contractor in the manner and form described in subpart C of part 424 of this chapter, the contractor must—\n(a) Determine if the items and services furnished are covered or otherwise reimbursable under title XVIII of the Act;\n(b) Determine any amounts payable and make payment accordingly; and\n(c) Notify the parties to the initial determination of the determination in accordance with § 405.921.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED","Subpart I—Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B)"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"6fd8ac1fb8f21dc7bbd875858d24cdef32739bf96327891708eed05a376c2467","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-405.912","next":"us/42-cfr-405.921"},"notice":"GroundRules: Original legal text. Not legal advice."}