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.

• Authority: 42 U.S.C. 1302 and 1395hh.
• Source: 47 FR 34094, Aug. 5, 1982, unless otherwise noted.

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

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