Regulations last checked for updates: Oct 17, 2024

Title 42 - Public Health last revised: Oct 15, 2024
§ 424.126 - Payment to the hospital.

(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.

authority: 42 U.S.C. 1302 and 1395hh
source: 53 FR 6634, Mar. 2, 1988, unless otherwise noted.
cite as: 42 CFR 424.126