42 C.F.R. § 424.126

Current through October 31, 2024
Section 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.

42 C.F.R. §424.126