42 C.F.R. § 424.124

Current through September 30, 2024
Section 424.124 - Conditions for payment for physician services and ambulance services
(a)Basic rules. Medicare Part B pays for physician and ambulance services if-
(1) They are furnished-
(i) To an individual who is entitled to Part B benefits; and
(ii) In connection with covered inpatient hospital services; and
(2) They meet the conditions set forth in paragraphs (b) and (c) of this section.
(b)Physician services.
(1) The physician services are services covered under Medicare Part B and are furnished-
(i) In the hospital, during a period of covered inpatient services; or
(ii) Outside the hospital, on the day of admission and for the same condition that required inpatient admission; and
(2) The physician is legally authorized to practice in the country where he or she furnishes the services.
(c)Ambulance services. The ambulance services are-
(1) Necessary because the use of other means of transportation is contraindicated by the beneficiary's condition; and
(2) Furnished by an ambulance that meets the definition in § 410.41 of this chapter.

42 C.F.R. §424.124

53 FR 6646, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988; 64 FR 3649, Jan. 25, 1999