Title 42

PART 416

Part 416 - Ambulatory Surgical Services

PART 416 - AMBULATORY SURGICAL SERVICES Authority:42 U.S.C. 1302 and 1395hh. Source:47 FR 34094, Aug. 5, 1982, unless otherwise noted.

42:3.0.1.1.3.1SUBPART A
Subpart A - General Provisions and Definitions
42:3.0.1.1.3.1.5.1SECTION 416.1
   416.1 Basis and scope.
42:3.0.1.1.3.1.5.2SECTION 416.2
   416.2 Definitions.
42:3.0.1.1.3.2SUBPART B
Subpart B - General Conditions and Requirements
42:3.0.1.1.3.2.5.1SECTION 416.25
   416.25 Basic requirements.
42:3.0.1.1.3.2.5.2SECTION 416.26
   416.26 Qualifying for an agreement.
42:3.0.1.1.3.2.5.3SECTION 416.30
   416.30 Terms of agreement with CMS.
42:3.0.1.1.3.2.5.4SECTION 416.35
   416.35 Termination of agreement.
42:3.0.1.1.3.3SUBPART C
Subpart C - Specific Conditions for Coverage
42:3.0.1.1.3.3.5.1SECTION 416.40
   416.40 Condition for coverage - Compliance with State licensure law.
42:3.0.1.1.3.3.5.2SECTION 416.41
   416.41 Condition for coverage - Governing body and management.
42:3.0.1.1.3.3.5.3SECTION 416.42
   416.42 Condition for coverage - Surgical services.
42:3.0.1.1.3.3.5.4SECTION 416.43
   416.43 Conditions for coverage - Quality assessment and performance improvement.
42:3.0.1.1.3.3.5.5SECTION 416.44
   416.44 Condition for coverage - Environment.
42:3.0.1.1.3.3.5.6SECTION 416.45
   416.45 Condition for coverage - Medical staff.
42:3.0.1.1.3.3.5.7SECTION 416.46
   416.46 Condition for coverage - Nursing services.
42:3.0.1.1.3.3.5.8SECTION 416.47
   416.47 Condition for coverage - Medical records.
42:3.0.1.1.3.3.5.9SECTION 416.48
   416.48 Condition for coverage - Pharmaceutical services.
42:3.0.1.1.3.3.5.10SECTION 416.49
   416.49 Condition for coverage - Laboratory and radiologic services.
42:3.0.1.1.3.3.5.11SECTION 416.50
   416.50 Condition for coverage - Patient rights.
42:3.0.1.1.3.3.5.12SECTION 416.51
   416.51 Conditions for coverage - Infection control.
42:3.0.1.1.3.3.5.13SECTION 416.52
   416.52 Conditions for coverage - Patient admission, assessment and discharge.
42:3.0.1.1.3.3.5.14SECTION 416.54
   416.54 Condition for coverage - Emergency preparedness.
42:3.0.1.1.3.4SUBPART D
Subpart D - Scope of Benefits for Services Furnished Before January 1, 2008
42:3.0.1.1.3.4.5.1SECTION 416.60
   416.60 General rules.
42:3.0.1.1.3.4.5.2SECTION 416.61
   416.61 Scope of facility services.
42:3.0.1.1.3.4.5.3SECTION 416.65
   416.65 Covered surgical procedures.
42:3.0.1.1.3.4.5.4SECTION 416.75
   416.75 Performance of listed surgical procedures on an inpatient hospital basis.
42:3.0.1.1.3.4.5.5SECTION 416.76
   416.76 Applicability.
42:3.0.1.1.3.5SUBPART E
Subpart E - Prospective Payment System for Facility Services Furnished Before January 1, 2008
42:3.0.1.1.3.5.5.1SECTION 416.120
   416.120 Basis for payment.
42:3.0.1.1.3.5.5.2SECTION 416.121
   416.121 Applicability.
42:3.0.1.1.3.5.5.3SECTION 416.125
   416.125 ASC facility services payment rate.
42:3.0.1.1.3.5.5.4SECTION 416.130
   416.130 Publication of revised payment methodologies.
42:3.0.1.1.3.5.5.5SECTION 416.140
   416.140 Surveys.
42:3.0.1.1.3.6SUBPART F
Subpart F - Coverage, Scope of ASC Services, and Prospective Payment System for ASC Services Furnished on or After January 1, 2008
42:3.0.1.1.3.6.5.1SECTION 416.160
   416.160 Basis and scope.
42:3.0.1.1.3.6.5.2SECTION 416.161
   416.161 Applicability of this subpart.
42:3.0.1.1.3.6.5.3SECTION 416.163
   416.163 General rules.
42:3.0.1.1.3.6.5.4SECTION 416.164
   416.164 Scope of ASC services.
42:3.0.1.1.3.6.5.5SECTION 416.166
   416.166 Covered surgical procedures.
42:3.0.1.1.3.6.5.6SECTION 416.167
   416.167 Basis of payment.
42:3.0.1.1.3.6.5.7SECTION 416.171
   416.171 Determination of payment rates for ASC services.
42:3.0.1.1.3.6.5.8SECTION 416.172
   416.172 Adjustments to national payment rates.
42:3.0.1.1.3.6.5.9SECTION 416.173
   416.173 Publication of revised payment methodologies and payment rates.
42:3.0.1.1.3.6.5.10SECTION 416.178
   416.178 Limitations on administrative and judicial review.
42:3.0.1.1.3.6.5.11SECTION 416.179
   416.179 Payment and coinsurance reduction for devices replaced without cost or when full or partial credit is received.
42:3.0.1.1.3.7SUBPART G
Subpart G - Adjustment in Payment Amounts for New Technology Intraocular Lenses Furnished by Ambulatory Service Centers
42:3.0.1.1.3.7.5.1SECTION 416.180
   416.180 Basis and scope.
42:3.0.1.1.3.7.5.2SECTION 416.185
   416.185 Process for establishing a new class of new technology IOLs.
42:3.0.1.1.3.7.5.3SECTION 416.190
   416.190 Request for review of payment amount.
42:3.0.1.1.3.7.5.4SECTION 416.195
   416.195 Determination of membership in new classes of new technology IOLs.
42:3.0.1.1.3.7.5.5SECTION 416.200
   416.200 Payment adjustment.
42:3.0.1.1.3.8SUBPART H
Subpart H - Requirements Under the Ambulatory Surgical Center Quality Reporting (ASCQR) Program
42:3.0.1.1.3.8.5.1SECTION 416.300
   416.300 Basis and scope of subpart.
42:3.0.1.1.3.8.5.2SECTION 416.305
   416.305 Participation and withdrawal requirements under the ASCQR Program.
42:3.0.1.1.3.8.5.3SECTION 416.310
   416.310 Data collection and submission requirements under the ASCQR Program.
42:3.0.1.1.3.8.5.4SECTION 416.315
   416.315 Public reporting of data under the ASCQR Program.
42:3.0.1.1.3.8.5.5SECTION 416.320
   416.320 Retention and removal of quality measures under the ASCQR Program.
42:3.0.1.1.3.8.5.6SECTION 416.325
   416.325 Measure maintenance under the ASCQR Program.
42:3.0.1.1.3.8.5.7SECTION 416.330
   416.330 Reconsiderations under the ASCQR Program.