| 42:2.0.1.2.13.1 | SUBPART A
| Subpart A - General Provisions | |
| 42:2.0.1.2.13.1.48.1 | SECTION 412.1
| 412.1 Scope of part. | |
| 42:2.0.1.2.13.1.48.2 | SECTION 412.2
| 412.2 Basis of payment. | |
| 42:2.0.1.2.13.1.48.3 | SECTION 412.3
| 412.3 Admissions. | |
| 42:2.0.1.2.13.1.48.4 | SECTION 412.4
| 412.4 Discharges and transfers. | |
| 42:2.0.1.2.13.1.48.5 | SECTION 412.6
| 412.6 Cost reporting periods subject to the prospective payment systems. | |
| 42:2.0.1.2.13.1.48.6 | SECTION 412.8
| 412.8 Publication of schedules for determining prospective payment rates. | |
| 42:2.0.1.2.13.1.48.7 | SECTION 412.10
| 412.10 Changes in the DRG classification system. | |
| 42:2.0.1.2.13.2 | SUBPART B
| Subpart B - Hospital Services Subject to and Excluded From the Prospective Payment Systems for Inpatient Operating Costs and Inpatient Capital-Related Costs | |
| 42:2.0.1.2.13.2.48.1 | SECTION 412.20
| 412.20 Hospital services subject to the prospective payment systems. | |
| 42:2.0.1.2.13.2.48.2 | SECTION 412.22
| 412.22 Excluded hospitals and hospital units: General rules. | |
| 42:2.0.1.2.13.2.48.3 | SECTION 412.23
| 412.23 Excluded hospitals: Classifications. | |
| 42:2.0.1.2.13.2.48.4 | SECTION 412.25
| 412.25 Excluded hospital units: Common requirements. | |
| 42:2.0.1.2.13.2.48.5 | SECTION 412.27
| 412.27 Excluded psychiatric units: Additional requirements. | |
| 42:2.0.1.2.13.2.48.6 | SECTION 412.29
| 412.29 Classification criteria for payment under the inpatient rehabilitation facility prospective payment system. | |
| 42:2.0.1.2.13.2.48.7 | SECTION 412.30
| 412.30 [Reserved] | |
| 42:2.0.1.2.13.3 | SUBPART C
| Subpart C - Conditions for Payment Under the Prospective Payment Systems for Inpatient Operating Costs and Inpatient Capital-Related Costs | |
| 42:2.0.1.2.13.3.48.1 | SECTION 412.40
| 412.40 General requirements. | |
| 42:2.0.1.2.13.3.48.2 | SECTION 412.42
| 412.42 Limitations on charges to beneficiaries. | |
| 42:2.0.1.2.13.3.48.3 | SECTION 412.44
| 412.44 Medical review requirements: Admissions and quality review. | |
| 42:2.0.1.2.13.3.48.4 | SECTION 412.46
| 412.46 Medical review requirements. | |
| 42:2.0.1.2.13.3.48.5 | SECTION 412.48
| 412.48 Denial of payment as a result of admissions and quality review. | |
| 42:2.0.1.2.13.3.48.6 | SECTION 412.50
| 412.50 Furnishing of inpatient hospital services directly or under arrangements. | |
| 42:2.0.1.2.13.3.48.7 | SECTION 412.52
| 412.52 Reporting and recordkeeping requirements. | |
| 42:2.0.1.2.13.4 | SUBPART D
| Subpart D - Basic Methodology for Determining Prospective Payment Federal Rates for Inpatient Operating Costs | |
| 42:2.0.1.2.13.4.48.1 | SECTION 412.60
| 412.60 DRG classification and weighting factors. | |
| 42:2.0.1.2.13.4.48.2 | SECTION 412.62
| 412.62 Federal rates for inpatient operating costs for fiscal year 1984. | |
| 42:2.0.1.2.13.4.48.3 | SECTION 412.63
| 412.63 Federal rates for inpatient operating costs for Federal fiscal years 1984 through 2004. | |
| 42:2.0.1.2.13.4.48.4 | SECTION 412.64
| 412.64 Federal rates for inpatient operating costs for Federal fiscal year 2005 and subsequent fiscal years. | |
| 42:2.0.1.2.13.5 | SUBPART E
| Subpart E - Determination of Transition Period Payment Rates for the Prospective Payment System for Inpatient Operating Costs | |
| 42:2.0.1.2.13.5.48.1 | SECTION 412.70
| 412.70 General description. | |
| 42:2.0.1.2.13.5.48.2 | SECTION 412.71
| 412.71 Determination of base-year inpatient operating costs. | |
| 42:2.0.1.2.13.5.48.3 | SECTION 412.72
| 412.72 Modification of base-year costs. | |
| 42:2.0.1.2.13.5.48.4 | SECTION 412.73
| 412.73 Determination of the hospital-specific rate based on a Federal fiscal year 1982 base period. | |
| 42:2.0.1.2.13.5.48.5 | SECTION 412.75
| 412.75 Determination of the hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. | |
| 42:2.0.1.2.13.5.48.6 | SECTION 412.76
| 412.76 Recovery of excess transition period payment amounts resulting from unlawful claims. | |
| 42:2.0.1.2.13.5.48.7 | SECTION 412.77
| 412.77 Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 1996 base period. | |
| 42:2.0.1.2.13.5.48.8 | SECTION 412.78
| 412.78 Determination of the hospital-specific rate for inpatient operating costs for sole community hospitals based on a Federal fiscal year 2006 base period. | |
| 42:2.0.1.2.13.5.48.9 | SECTION 412.79
| 412.79 Determination of the hospital-specific rate for inpatient operating costs for Medicare-dependent, small rural hospitals based on a Federal fiscal year 2002 base period. | |
| 42:2.0.1.2.13.6 | SUBPART F
| Subpart F - Payments for Outlier Cases, Special Treatment Payment for New Technology, and Payment Adjustment for Certain Replaced Devices | |
| 42:2.0.1.2.13.6.48 | SUBJGRP 48
| Payment for Outlier Cases | |
| 42:2.0.1.2.13.6.48.1 | SECTION 412.80
| 412.80 Outlier cases: General provisions. | |
| 42:2.0.1.2.13.6.48.2 | SECTION 412.82
| 412.82 Payment for extended length-of-stay cases (day outliers). | |
| 42:2.0.1.2.13.6.48.3 | SECTION 412.84
| 412.84 Payment for extraordinarily high-cost cases (cost outliers). | |
| 42:2.0.1.2.13.6.49 | SUBJGRP 49
| Payment Adjustment for Certain Clinical Trial Cases and Expanded Access Use Immunotherapy | |
| 42:2.0.1.2.13.6.49.4 | SECTION 412.85
| 412.85 Payment adjustment for certain clinical trial and expanded access use immunotherapy cases. | |
| 42:2.0.1.2.13.6.49.5 | SECTION 412.83
| 412.83 Payment for extraordinarily high-cost day outliers. | |
| 42:2.0.1.2.13.6.49.6 | SECTION 412.86
| 412.86 [Reserved] | |
| 42:2.0.1.2.13.6.50 | SUBJGRP 50
| Additional Special Payment for Certain New Technology | |
| 42:2.0.1.2.13.6.50.7 | SECTION 412.87
| 412.87 Additional payment for new medical services and technologies: General provisions. | |
| 42:2.0.1.2.13.6.50.8 | SECTION 412.88
| 412.88 Additional payment for new medical service or technology. | |
| 42:2.0.1.2.13.6.51 | SUBJGRP 51
| Payment Adjustment for Certain Replaced Devices | |
| 42:2.0.1.2.13.6.51.9 | SECTION 412.89
| 412.89 Payment adjustment for certain replaced devices. | |
| 42:2.0.1.2.13.7 | SUBPART G
| Subpart G - Special Treatment of Certain Facilities Under the Prospective Payment System for Inpatient Operating Costs | |
| 42:2.0.1.2.13.7.52.1 | SECTION 412.90
| 412.90 General rules. | |
| 42:2.0.1.2.13.7.52.2 | SECTION 412.92
| 412.92 Special treatment: Sole community hospitals. | |
| 42:2.0.1.2.13.7.52.3 | SECTION 412.96
| 412.96 Special treatment: Referral centers. | |
| 42:2.0.1.2.13.7.52.4 | SECTION 412.98
| 412.98 [Reserved] | |
| 42:2.0.1.2.13.7.52.5 | SECTION 412.100
| 412.100 Special treatment: Renal transplantation centers. | |
| 42:2.0.1.2.13.7.52.6 | SECTION 412.101
| 412.101 Special treatment: Inpatient hospital payment adjustment for low-volume hospitals. | |
| 42:2.0.1.2.13.7.52.7 | SECTION 412.102
| 412.102 Special treatment: Hospitals located in areas that are changing from urban to rural as a result of a geographic redesignation. | |
| 42:2.0.1.2.13.7.52.8 | SECTION 412.103
| 412.103 Special treatment: Hospitals located in urban areas and that apply for reclassification as rural. | |
| 42:2.0.1.2.13.7.52.9 | SECTION 412.104
| 412.104 Special treatment: Hospitals with high percentage of ESRD discharges. | |
| 42:2.0.1.2.13.7.52.10 | SECTION 412.105
| 412.105 Special treatment: Hospitals that incur indirect costs for graduate medical education programs. | |
| 42:2.0.1.2.13.7.52.11 | SECTION 412.106
| 412.106 Special treatment: Hospitals that serve a disproportionate share of low-income patients. | |
| 42:2.0.1.2.13.7.52.12 | SECTION 412.107
| 412.107 Special treatment: Hospitals that receive an additional update for FYs 1998 and 1999. | |
| 42:2.0.1.2.13.7.52.13 | SECTION 412.108
| 412.108 Special treatment: Medicare-dependent, small rural hospitals. | |
| 42:2.0.1.2.13.7.52.14 | SECTION 412.109
| 412.109 Special treatment: Essential access community hospitals (EACHs). | |
| 42:2.0.1.2.13.8 | SUBPART H
| Subpart H - Payments to Hospitals Under the Prospective Payment Systems | |
| 42:2.0.1.2.13.8.52.1 | SECTION 412.110
| 412.110 Total Medicare payment. | |
| 42:2.0.1.2.13.8.52.2 | SECTION 412.112
| 412.112 Payments determined on a per case basis. | |
| 42:2.0.1.2.13.8.52.3 | SECTION 412.113
| 412.113 Other payments. | |
| 42:2.0.1.2.13.8.52.4 | SECTION 412.115
| 412.115 Additional payments. | |
| 42:2.0.1.2.13.8.52.5 | SECTION 412.116
| 412.116 Method of payment. | |
| 42:2.0.1.2.13.8.52.6 | SECTION 412.120
| 412.120 Reductions to total payments. | |
| 42:2.0.1.2.13.8.52.7 | SECTION 412.125
| 412.125 Effect of change of ownership on payments under the prospective payment systems. | |
| 42:2.0.1.2.13.8.52.8 | SECTION 412.130
| 412.130 Retroactive adjustments for incorrectly excluded hospitals and units. | |
| 42:2.0.1.2.13.8.52.9 | SECTION 412.140
| 412.140 Participation, data submission, and validation requirements under the Hospital Inpatient Quality Reporting (IQR) Program. | |
| 42:2.0.1.2.13.9 | SUBPART I
| Subpart I - Adjustments to the Base Operating DRG Payment Amounts Under the Prospective Payment Systems for Inpatient Operating Costs | |
| 42:2.0.1.2.13.9.52 | SUBJGRP 52
| Payment Adjustments Under the Hospital Readmissions Reduction Program | |
| 42:2.0.1.2.13.9.52.1 | SECTION 412.150
| 412.150 Basis and scope of subpart. | |
| 42:2.0.1.2.13.9.52.2 | SECTION 412.152
| 412.152 Definitions for the Hospital Readmissions Reduction Program. | |
| 42:2.0.1.2.13.9.52.3 | SECTION 412.154
| 412.154 Payment adjustments under the Hospital Readmissions Reduction Program. | |
| 42:2.0.1.2.13.9.52.4 | SECTION 412.155-412.159
| 412.155-412.159 [Reserved] | |
| 42:2.0.1.2.13.9.53 | SUBJGRP 53
| Incentive Payments Under the Hospital Value-Based Purchasing Program | |
| 42:2.0.1.2.13.9.53.5 | SECTION 412.160
| 412.160 Definitions for the Hospital Value-Based Purchasing (VBP) Program. | |
| 42:2.0.1.2.13.9.53.6 | SECTION 412.161
| 412.161 Applicability of the Hospital Value-Based Purchasing (VBP) Program | |
| 42:2.0.1.2.13.9.53.7 | SECTION 412.162
| 412.162 Process for reducing the base operating DRG payment amount and applying the value-based incentive payment amount adjustment under the Hospital Value-Based Purchasing (VBP) Program. | |
| 42:2.0.1.2.13.9.53.8 | SECTION 412.163
| 412.163 Process for making hospital-specific performance information under the Hospital Value-Based Purchasing (VBP) Program available to the public. | |
| 42:2.0.1.2.13.9.53.9 | SECTION 412.164
| 412.164 Measure selection under the Hospital Value-Based Purchasing (VBP) Program. | |
| 42:2.0.1.2.13.9.53.10 | SECTION 412.165
| 412.165 Performance scoring under the Hospital Value-Based Purchasing (VBP) Program. | |
| 42:2.0.1.2.13.9.53.11 | SECTION 412.167
| 412.167 Appeal under the Hospital Value-Based Purchasing (VBP) Program. | |
| 42:2.0.1.2.13.9.53.12 | SECTION 412.168-412.169
| 412.168-412.169 [Reserved] | |
| 42:2.0.1.2.13.9.54 | SUBJGRP 54
| Payment Adjustments Under the Hospital-Acquired Condition Reduction Program | |
| 42:2.0.1.2.13.9.54.13 | SECTION 412.170
| 412.170 Definitions for the Hospital-Acquired Condition Reduction Program. | |
| 42:2.0.1.2.13.9.54.14 | SECTION 412.172
| 412.172 Payment adjustments under the Hospital-Acquired Condition Reduction Program. | |
| 42:2.0.1.2.13.9.54.15 | SECTION 412.190
| 412.190 Overall Hospital Quality Star Rating. | |
| 42:2.0.1.2.13.10 | SUBPART J
| Subpart J [Reserved] | |
| 42:2.0.1.2.13.11 | SUBPART K
| Subpart K - Prospective Payment System for Inpatient Operating Costs for Hospitals Located in Puerto Rico | |
| 42:2.0.1.2.13.11.55.1 | SECTION 412.200
| 412.200 General provisions. | |
| 42:2.0.1.2.13.11.55.2 | SECTION 412.204
| 412.204 Payment to hospitals located in Puerto Rico. | |
| 42:2.0.1.2.13.11.55.3 | SECTION 412.208
| 412.208 Puerto Rico rates for Federal fiscal year 1988. | |
| 42:2.0.1.2.13.11.55.4 | SECTION 412.210
| 412.210 Puerto Rico rates for Federal fiscal years 1989 through 2003. | |
| 42:2.0.1.2.13.11.55.5 | SECTION 412.211
| 412.211 Puerto Rico rates for Federal fiscal year 2004 and subsequent fiscal years. | |
| 42:2.0.1.2.13.11.55.6 | SECTION 412.212
| 412.212 National rate. | |
| 42:2.0.1.2.13.11.55.7 | SECTION 412.220
| 412.220 Special treatment of certain hospitals located in Puerto Rico. | |
| 42:2.0.1.2.13.12 | SUBPART L
| Subpart L - The Medicare Geographic Classification Review Board | |
| 42:2.0.1.2.13.12.55 | SUBJGRP 55
| Criteria and Conditions for Redesignation | |
| 42:2.0.1.2.13.12.55.1 | SECTION 412.230
| 412.230 Criteria for an individual hospital seeking redesignation to another rural area or an urban area. | |
| 42:2.0.1.2.13.12.55.2 | SECTION 412.232
| 412.232 Criteria for all hospitals in a rural county seeking urban redesignation. | |
| 42:2.0.1.2.13.12.55.3 | SECTION 412.234
| 412.234 Criteria for all hospitals in an urban county seeking redesignation to another urban area. | |
| 42:2.0.1.2.13.12.55.4 | SECTION 412.235
| 412.235 Criteria for all hospitals in a State seeking a statewide wage index redesignation. | |
| 42:2.0.1.2.13.12.56 | SUBJGRP 56
| Composition and Procedures | |
| 42:2.0.1.2.13.12.56.5 | SECTION 412.246
| 412.246 MGCRB members. | |
| 42:2.0.1.2.13.12.56.6 | SECTION 412.248
| 412.248 Number of members needed for a decision or a hearing. | |
| 42:2.0.1.2.13.12.56.7 | SECTION 412.250
| 412.250 Sources of MGCRB's authority. | |
| 42:2.0.1.2.13.12.56.8 | SECTION 412.252
| 412.252 Applications. | |
| 42:2.0.1.2.13.12.56.9 | SECTION 412.254
| 412.254 Proceedings before MGCRB. | |
| 42:2.0.1.2.13.12.56.10 | SECTION 412.256
| 412.256 Application requirements. | |
| 42:2.0.1.2.13.12.56.11 | SECTION 412.258
| 412.258 Parties to MGCRB proceeding. | |
| 42:2.0.1.2.13.12.56.12 | SECTION 412.260
| 412.260 Time and place of the oral hearing. | |
| 42:2.0.1.2.13.12.56.13 | SECTION 412.262
| 412.262 Disqualification of an MGCRB member. | |
| 42:2.0.1.2.13.12.56.14 | SECTION 412.264
| 412.264 Evidence and comments in MGCRB proceeding. | |
| 42:2.0.1.2.13.12.56.15 | SECTION 412.266
| 412.266 Availability of wage data. | |
| 42:2.0.1.2.13.12.56.16 | SECTION 412.268
| 412.268 Subpoenas. | |
| 42:2.0.1.2.13.12.56.17 | SECTION 412.270
| 412.270 Witnesses. | |
| 42:2.0.1.2.13.12.56.18 | SECTION 412.272
| 412.272 Record of proceedings before the MGCRB. | |
| 42:2.0.1.2.13.12.56.19 | SECTION 412.273
| 412.273 Withdrawing an application, terminating an approved 3-year reclassification, or canceling a previous withdrawal or termination. | |
| 42:2.0.1.2.13.12.56.20 | SECTION 412.274
| 412.274 Scope and effect of an MGCRB decision. | |
| 42:2.0.1.2.13.12.56.21 | SECTION 412.276
| 412.276 Timing of MGCRB decision and its appeal. | |
| 42:2.0.1.2.13.12.56.22 | SECTION 412.278
| 412.278 Administrator's review. | |
| 42:2.0.1.2.13.12.56.23 | SECTION 412.280
| 412.280 Representation. | |
| 42:2.0.1.2.13.13 | SUBPART M
| Subpart M - Prospective Payment System for Inpatient Hospital Capital Costs | |
| 42:2.0.1.2.13.13.57 | SUBJGRP 57
| General Provisions | |
| 42:2.0.1.2.13.13.57.1 | SECTION 412.300
| 412.300 Scope of subpart and definition. | |
| 42:2.0.1.2.13.13.57.2 | SECTION 412.302
| 412.302 Introduction to capital costs. | |
| 42:2.0.1.2.13.13.57.3 | SECTION 412.304
| 412.304 Implementation of the capital prospective payment system. | |
| 42:2.0.1.2.13.13.58 | SUBJGRP 58
| Basic Methodology for Determining the Federal Rate for Capital-Related Costs | |
| 42:2.0.1.2.13.13.58.4 | SECTION 412.308
| 412.308 Determining and updating the Federal rate. | |
| 42:2.0.1.2.13.13.58.5 | SECTION 412.312
| 412.312 Payment based on the Federal rate. | |
| 42:2.0.1.2.13.13.58.6 | SECTION 412.316
| 412.316 Geographic adjustment factors. | |
| 42:2.0.1.2.13.13.58.7 | SECTION 412.320
| 412.320 Disproportionate share adjustment factor. | |
| 42:2.0.1.2.13.13.58.8 | SECTION 412.322
| 412.322 Indirect medical education adjustment factor. | |
| 42:2.0.1.2.13.13.59 | SUBJGRP 59
| Determination of Transition Period Payment Rates for Capital-Related Costs | |
| 42:2.0.1.2.13.13.59.9 | SECTION 412.324
| 412.324 General description. | |
| 42:2.0.1.2.13.13.59.10 | SECTION 412.328
| 412.328 Determining and updating the hospital-specific rate. | |
| 42:2.0.1.2.13.13.59.11 | SECTION 412.331
| 412.331 Determining hospital-specific rates in cases of hospital merger, consolidation, or dissolution. | |
| 42:2.0.1.2.13.13.59.12 | SECTION 412.332
| 412.332 Payment based on the hospital-specific rate. | |
| 42:2.0.1.2.13.13.59.13 | SECTION 412.336
| 412.336 Transition period payment methodologies. | |
| 42:2.0.1.2.13.13.59.14 | SECTION 412.340
| 412.340 Fully prospective payment methodology. | |
| 42:2.0.1.2.13.13.59.15 | SECTION 412.344
| 412.344 Hold-harmless payment methodology. | |
| 42:2.0.1.2.13.13.59.16 | SECTION 412.348
| 412.348 Exception payments. | |
| 42:2.0.1.2.13.13.59.17 | SECTION 412.352
| 412.352 Budget neutrality adjustment. | |
| 42:2.0.1.2.13.13.60 | SUBJGRP 60
| Special Rules for Puerto Rico Hospitals | |
| 42:2.0.1.2.13.13.60.18 | SECTION 412.370
| 412.370 General provisions for hospitals located in Puerto Rico. | |
| 42:2.0.1.2.13.13.60.19 | SECTION 412.374
| 412.374 Payments to hospitals located in Puerto Rico. | |
| 42:2.0.1.2.13.14 | SUBPART N
| Subpart N - Prospective Payment System for Inpatient Hospital Services of Inpatient Psychiatric Facilities | |
| 42:2.0.1.2.13.14.61.1 | SECTION 412.400
| 412.400 Basis and scope of subpart. | |
| 42:2.0.1.2.13.14.61.2 | SECTION 412.402
| 412.402 Definitions. | |
| 42:2.0.1.2.13.14.61.3 | SECTION 412.404
| 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. | |
| 42:2.0.1.2.13.14.61.4 | SECTION 412.405
| 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. | |
| 42:2.0.1.2.13.14.61.5 | SECTION 412.422
| 412.422 Basis of payment. | |
| 42:2.0.1.2.13.14.61.6 | SECTION 412.424
| 412.424 Methodology for calculating the Federal per diem payment amount. | |
| 42:2.0.1.2.13.14.61.7 | SECTION 412.426
| 412.426 Transition period. | |
| 42:2.0.1.2.13.14.61.8 | SECTION 412.428
| 412.428 Publication of changes to the inpatient psychiatric facility prospective payment system. | |
| 42:2.0.1.2.13.14.61.9 | SECTION 412.432
| 412.432 Method of payment under the inpatient psychiatric facility prospective payment system. | |
| 42:2.0.1.2.13.14.61.10 | SECTION 412.434
| 412.434 Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. | |
| 42:2.0.1.2.13.15 | SUBPART O
| Subpart O - Prospective Payment System for Long-Term Care Hospitals | |
| 42:2.0.1.2.13.15.61.1 | SECTION 412.500
| 412.500 Basis and scope of subpart. | |
| 42:2.0.1.2.13.15.61.2 | SECTION 412.503
| 412.503 Definitions. | |
| 42:2.0.1.2.13.15.61.3 | SECTION 412.505
| 412.505 Conditions for payment under the prospective payment system for long-term care hospitals. | |
| 42:2.0.1.2.13.15.61.4 | SECTION 412.507
| 412.507 Limitation on charges to beneficiaries. | |
| 42:2.0.1.2.13.15.61.5 | SECTION 412.508
| 412.508 Medical review requirements. | |
| 42:2.0.1.2.13.15.61.6 | SECTION 412.509
| 412.509 Furnishing of inpatient hospital services directly or under arrangement. | |
| 42:2.0.1.2.13.15.61.7 | SECTION 412.511
| 412.511 Reporting and recordkeeping requirements. | |
| 42:2.0.1.2.13.15.61.8 | SECTION 412.513
| 412.513 Patient classification system. | |
| 42:2.0.1.2.13.15.61.9 | SECTION 412.515
| 412.515 LTC-DRG weighting factors. | |
| 42:2.0.1.2.13.15.61.10 | SECTION 412.517
| 412.517 Revision of LTC-DRG group classifications and weighting factors. | |
| 42:2.0.1.2.13.15.61.11 | SECTION 412.521
| 412.521 Basis of payment. | |
| 42:2.0.1.2.13.15.61.12 | SECTION 412.522
| 412.522 Application of site neutral payment rate. | |
| 42:2.0.1.2.13.15.61.13 | SECTION 412.523
| 412.523 Methodology for calculating the Federal prospective payment rates. | |
| 42:2.0.1.2.13.15.61.14 | SECTION 412.525
| 412.525 Adjustments to the Federal prospective payment. | |
| 42:2.0.1.2.13.15.61.15 | SECTION 412.526
| 412.526 Payment provisions for a “subclause (II)” long-term care hospital. | |
| 42:2.0.1.2.13.15.61.16 | SECTION 412.529
| 412.529 Special payment provision for short-stay outliers. | |
| 42:2.0.1.2.13.15.61.17 | SECTION 412.531
| 412.531 Special payment provisions when an interruption of a stay occurs in a long-term care hospital. | |
| 42:2.0.1.2.13.15.61.18 | SECTION 412.533
| 412.533 Transition payments. | |
| 42:2.0.1.2.13.15.61.19 | SECTION 412.534
| 412.534 Special payment provisions for long-term care hospitals-within-hospitals and satellites of long-term care hospitals, effective for discharges occurring in cost reporting periods beginning on or before September 30, 2016. | |
| 42:2.0.1.2.13.15.61.20 | SECTION 412.535
| 412.535 Publication of the Federal prospective payment rates. | |
| 42:2.0.1.2.13.15.61.21 | SECTION 412.536
| 412.536 Special payment provisions for long-term care hospitals and satellites of long-term care hospitals that discharge Medicare patients admitted from a hospital not located in the same building or on the same campus as the long-term care hospital or satellite of the long-term care hospital, effective for discharges occurring on or before September 30, 2016 or in cost reporting periods beginning on or before June 30, 2016. | |
| 42:2.0.1.2.13.15.61.22 | SECTION 412.538
| 412.538 [Reserved] | |
| 42:2.0.1.2.13.15.61.23 | SECTION 412.540
| 412.540 Method of payment for preadmission services under the long-term care hospital prospective payment system. | |
| 42:2.0.1.2.13.15.61.24 | SECTION 412.541
| 412.541 Method of payment under the long-term care hospital prospective payment system. | |
| 42:2.0.1.2.13.15.61.25 | SECTION 412.560
| 412.560 Requirements under the Long-Term Care Hospital Quality Reporting Program (LTCH QRP). | |
| 42:2.0.1.2.13.16 | SUBPART P
| Subpart P - Prospective Payment for Inpatient Rehabilitation Hospitals and Rehabilitation Units | |
| 42:2.0.1.2.13.16.61.1 | SECTION 412.600
| 412.600 Basis and scope of subpart. | |
| 42:2.0.1.2.13.16.61.2 | SECTION 412.602
| 412.602 Definitions. | |
| 42:2.0.1.2.13.16.61.3 | SECTION 412.604
| 412.604 Conditions for payment under the prospective payment system for inpatient rehabilitation facilities. | |
| 42:2.0.1.2.13.16.61.4 | SECTION 412.606
| 412.606 Patient assessments. | |
| 42:2.0.1.2.13.16.61.5 | SECTION 412.608
| 412.608 Patients' rights regarding the collection of patient assessment data. | |
| 42:2.0.1.2.13.16.61.6 | SECTION 412.610
| 412.610 Assessment schedule. | |
| 42:2.0.1.2.13.16.61.7 | SECTION 412.612
| 412.612 Coordination of the collection of patient assessment data. | |
| 42:2.0.1.2.13.16.61.8 | SECTION 412.614
| 412.614 Transmission of patient assessment data. | |
| 42:2.0.1.2.13.16.61.9 | SECTION 412.616
| 412.616 Release of information collected using the patient assessment instrument. | |
| 42:2.0.1.2.13.16.61.10 | SECTION 412.618
| 412.618 Assessment process for interrupted stays. | |
| 42:2.0.1.2.13.16.61.11 | SECTION 412.620
| 412.620 Patient classification system. | |
| 42:2.0.1.2.13.16.61.12 | SECTION 412.622
| 412.622 Basis of payment. | |
| 42:2.0.1.2.13.16.61.13 | SECTION 412.624
| 412.624 Methodology for calculating the Federal prospective payment rates. | |
| 42:2.0.1.2.13.16.61.14 | SECTION 412.626
| 412.626 Transition period. | |
| 42:2.0.1.2.13.16.61.15 | SECTION 412.628
| 412.628 Publication of the Federal prospective payment rates. | |
| 42:2.0.1.2.13.16.61.16 | SECTION 412.630
| 412.630 Limitation on review. | |
| 42:2.0.1.2.13.16.61.17 | SECTION 412.632
| 412.632 Method of payment under the inpatient rehabilitation facility prospective payment system. | |
| 42:2.0.1.2.13.16.61.18 | SECTION 412.634
| 412.634 Requirements under the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP). | |