Regulations last checked for updates: Nov 22, 2024

Title 42 - Public Health last revised: Nov 19, 2024
§ 424.53 - Payment to the beneficiary.

Medicare pays the beneficiary for the following services, if covered, in the specified circumstances:

(a) Emergency inpatient and outpatient services furnished by a nonparticipating U.S. hospital that has not elected to claim payment in accordance with subpart G of this part.

(b) Certain medical and other health services covered under Medicare Part B and furnished by a nonparticipating U.S. hospital, if the hospital does not receive assigned payment as a supplier under § 424.55.

(c) Emergency or nonemergency services furnished by a foreign hospital if the hospital does not have in effect an election to claim payment in accordance with subpart H of this part.

(d) Physician and ambulance services furnished outside the United States.

(e) Services furnished by a supplier if the claim has not been assigned to the supplier.

authority: 42 U.S.C. 1302 and 1395hh
source: 53 FR 6634, Mar. 2, 1988, unless otherwise noted.
cite as: 42 CFR 424.53