Section 419.21 - Hospital services subject to the outpatient prospective payment systemExcept for services described in § 419.22 , effective for services furnished on or after July 1, 2000, payment is made under the hospital outpatient prospective payment system for the following:
(a) Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part.(b) Services designated by the Secretary that are covered under Medicare Part B when furnished to hospital inpatients who are either not entitled to benefits under Part A or who have exhausted their Part A benefits but are entitled to benefits under Part B of the program.(c) Partial hospitalization services and intensive outpatient services furnished by community mental health centers (CMHCs).(d) The following medical and other health services furnished by a home health agency (HHA) to patients who are not under an HHA plan or treatment or by a hospice program furnishing services to patients outside the hospice benefit:(e)(1) Effective January 1, 2005 through December 31, 2008, an initial preventive physical examination, as defined in § 410.16 of this chapter, if the examination is performed no later than 6 months after the individual's initial Part B coverage date that begins on or after January 1, 2005.(2) Effective January 1, 2009, an initial preventive physical examination, as defined in § 410.16 of this chapter, if the examination is performed no later than 12 months after the date of the individual's initial enrollment in Part B. 65 FR 18542 , Apr. 7, 2000, as amended at 67 FR 66813 , Nov. 1, 2002; 69 FR 65863 , Nov. 15, 2004; 71 FR 68227 , Nov. 24, 2006: 75 FR 72265 , Nov. 24, 2010; 88 FR 82180 , Nov. 22, 2023