| 42:3.0.1.1.11.1 | SUBPART A
| Subpart A - General Provisions | |
| 42:3.0.1.1.11.1.11.1 | SECTION 424.1
| 424.1 Basis and scope. | |
| 42:3.0.1.1.11.1.11.2 | SECTION 424.3
| 424.3 Definitions. | |
| 42:3.0.1.1.11.1.11.3 | SECTION 424.5
| 424.5 Basic conditions. | |
| 42:3.0.1.1.11.1.11.4 | SECTION 424.7
| 424.7 General limitations. | |
| 42:3.0.1.1.11.2 | SUBPART B
| Subpart B - Certification and Plan Requirements | |
| 42:3.0.1.1.11.2.11.1 | SECTION 424.10
| 424.10 Purpose and scope. | |
| 42:3.0.1.1.11.2.11.2 | SECTION 424.11
| 424.11 General procedures. | |
| 42:3.0.1.1.11.2.11.3 | SECTION 424.13
| 424.13 Requirements for inpatient services of hospitals other than inpatient psychiatric facilities. | |
| 42:3.0.1.1.11.2.11.4 | SECTION 424.14
| 424.14 Requirements for inpatient services of inpatient psychiatric facilities. | |
| 42:3.0.1.1.11.2.11.5 | SECTION 424.15
| 424.15 Requirements for inpatient CAH services. | |
| 42:3.0.1.1.11.2.11.6 | SECTION 424.16
| 424.16 Timing of certification for individual admitted to a hospital before entitlement to Medicare benefits. | |
| 42:3.0.1.1.11.2.11.7 | SECTION 424.20
| 424.20 Requirements for posthospital SNF care. | |
| 42:3.0.1.1.11.2.11.8 | SECTION 424.22
| 424.22 Requirements for home health services. | |
| 42:3.0.1.1.11.2.11.9 | SECTION 424.24
| 424.24 Requirements for medical and other health services furnished by providers under Medicare Part B. | |
| 42:3.0.1.1.11.2.11.10 | SECTION 424.27
| 424.27 Requirements for comprehensive outpatient rehabilitation facility (CORF) services. | |
| 42:3.0.1.1.11.3 | SUBPART C
| Subpart C - Claims for Payment | |
| 42:3.0.1.1.11.3.11.1 | SECTION 424.30
| 424.30 Scope. | |
| 42:3.0.1.1.11.3.11.2 | SECTION 424.32
| 424.32 Basic requirements for all claims. | |
| 42:3.0.1.1.11.3.11.3 | SECTION 424.33
| 424.33 Additional requirements: Claims for services of providers and claims by suppliers and nonparticipating hospitals. | |
| 42:3.0.1.1.11.3.11.4 | SECTION 424.34
| 424.34 Additional requirements: Beneficiary's claim for direct payment. | |
| 42:3.0.1.1.11.3.11.5 | SECTION 424.36
| 424.36 Signature requirements. | |
| 42:3.0.1.1.11.3.11.6 | SECTION 424.37
| 424.37 Evidence of authority to sign on behalf of the beneficiary. | |
| 42:3.0.1.1.11.3.11.7 | SECTION 424.40
| 424.40 Request for payment effective for more than one claim. | |
| 42:3.0.1.1.11.3.11.8 | SECTION 424.44
| 424.44 Time limits for filing claims. | |
| 42:3.0.1.1.11.4 | SUBPART D
| Subpart D - To Whom Payment Is Ordinarily Made | |
| 42:3.0.1.1.11.4.11.1 | SECTION 424.50
| 424.50 Scope. | |
| 42:3.0.1.1.11.4.11.2 | SECTION 424.51
| 424.51 Payment to the provider. | |
| 42:3.0.1.1.11.4.11.3 | SECTION 424.52
| 424.52 Payment to a nonparticipating hospital. | |
| 42:3.0.1.1.11.4.11.4 | SECTION 424.53
| 424.53 Payment to the beneficiary. | |
| 42:3.0.1.1.11.4.11.5 | SECTION 424.54
| 424.54 Payment to the beneficiary's legal guardian or representative payee. | |
| 42:3.0.1.1.11.4.11.6 | SECTION 424.55
| 424.55 Payment to the supplier. | |
| 42:3.0.1.1.11.4.11.7 | SECTION 424.56
| 424.56 Payment to a beneficiary and to a supplier. | |
| 42:3.0.1.1.11.4.11.8 | SECTION 424.57
| 424.57 Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier billing privileges. | |
| 42:3.0.1.1.11.4.11.9 | SECTION 424.58
| 424.58 Accreditation. | |
| 42:3.0.1.1.11.5 | SUBPART E
| Subpart E - To Whom Payment is Made in Special Situations | |
| 42:3.0.1.1.11.5.11.1 | SECTION 424.60
| 424.60 Scope. | |
| 42:3.0.1.1.11.5.11.2 | SECTION 424.62
| 424.62 Payment after beneficiary's death: Bill has been paid. | |
| 42:3.0.1.1.11.5.11.3 | SECTION 424.64
| 424.64 Payment after beneficiary's death: Bill has not been paid. | |
| 42:3.0.1.1.11.5.11.4 | SECTION 424.66
| 424.66 Payment to entities that provide coverage complementary to Medicare Part B. | |
| 42:3.0.1.1.11.5.11.5 | SECTION 424.67
| 424.67 Enrollment requirements for opioid treatment programs (OTP). | |
| 42:3.0.1.1.11.5.11.6 | SECTION 424.68
| 424.68 Enrollment requirements for home infusion therapy suppliers. | |
| 42:3.0.1.1.11.6 | SUBPART F
| Subpart F - Limitations on Assignment and Reassignment of Claims | |
| 42:3.0.1.1.11.6.11.1 | SECTION 424.70
| 424.70 Basis and scope. | |
| 42:3.0.1.1.11.6.11.2 | SECTION 424.71
| 424.71 Definitions. | |
| 42:3.0.1.1.11.6.11.3 | SECTION 424.73
| 424.73 Prohibition of assignment of claims by providers. | |
| 42:3.0.1.1.11.6.11.4 | SECTION 424.74
| 424.74 Termination of provider agreement. | |
| 42:3.0.1.1.11.6.11.5 | SECTION 424.80
| 424.80 Prohibition of reassignment of claims by suppliers. | |
| 42:3.0.1.1.11.6.11.6 | SECTION 424.82
| 424.82 Revocation of right to receive assigned benefits. | |
| 42:3.0.1.1.11.6.11.7 | SECTION 424.83
| 424.83 Hearings on revocation of right to receive assigned benefits. | |
| 42:3.0.1.1.11.6.11.8 | SECTION 424.84
| 424.84 Final determination on revocation of right to receive assigned benefits. | |
| 42:3.0.1.1.11.6.11.9 | SECTION 424.86
| 424.86 Prohibition of assignment of claims by beneficiaries. | |
| 42:3.0.1.1.11.6.11.10 | SECTION 424.90
| 424.90 Court ordered assignments: Conditions and limitations. | |
| 42:3.0.1.1.11.7 | SUBPART G
| Subpart G - Special Conditions: Emergency Services Furnished by a Nonparticipating Hospital | |
| 42:3.0.1.1.11.7.11.1 | SECTION 424.100
| 424.100 Scope. | |
| 42:3.0.1.1.11.7.11.2 | SECTION 424.101
| 424.101 Definitions. | |
| 42:3.0.1.1.11.7.11.3 | SECTION 424.102
| 424.102 Situations that do not constitute an emergency. | |
| 42:3.0.1.1.11.7.11.4 | SECTION 424.103
| 424.103 Conditions for payment for emergency services. | |
| 42:3.0.1.1.11.7.11.5 | SECTION 424.104
| 424.104 Election to claim payment for emergency services furnished during a calendar year. | |
| 42:3.0.1.1.11.7.11.6 | SECTION 424.106
| 424.106 Criteria for determining whether the hospital was the most accessible. | |
| 42:3.0.1.1.11.7.11.7 | SECTION 424.108
| 424.108 Payment to a hospital. | |
| 42:3.0.1.1.11.7.11.8 | SECTION 424.109
| 424.109 Payment to the beneficiary. | |
| 42:3.0.1.1.11.8 | SUBPART H
| Subpart H - Special Conditions: Services Furnished in a Foreign Country | |
| 42:3.0.1.1.11.8.11.1 | SECTION 424.120
| 424.120 Scope. | |
| 42:3.0.1.1.11.8.11.2 | SECTION 424.121
| 424.121 Scope of payments. | |
| 42:3.0.1.1.11.8.11.3 | SECTION 424.122
| 424.122 Conditions for payment for emergency inpatient hospital services. | |
| 42:3.0.1.1.11.8.11.4 | SECTION 424.123
| 424.123 Conditions for payment for nonemergency inpatient services furnished by a hospital closer to the individual's residence. | |
| 42:3.0.1.1.11.8.11.5 | SECTION 424.124
| 424.124 Conditions for payment for physician services and ambulance services. | |
| 42:3.0.1.1.11.8.11.6 | SECTION 424.126
| 424.126 Payment to the hospital. | |
| 42:3.0.1.1.11.8.11.7 | SECTION 424.127
| 424.127 Payment to the beneficiary. | |
| 42:3.0.1.1.11.9 | SUBPART I
| Subpart I - Requirements for Medicare Diabetes Prevention Program Suppliers and Beneficiary Engagement Incentives Under the Medicare Diabetes Prevention Program Expanded Model | |
| 42:3.0.1.1.11.9.11.1 | SECTION 424.200
| 424.200 Scope. | |
| 42:3.0.1.1.11.9.11.2 | SECTION 424.205
| 424.205 Requirements for Medicare Diabetes Prevention Program suppliers. | |
| 42:3.0.1.1.11.9.11.3 | SECTION 424.210
| 424.210 Beneficiary engagement incentives under the Medicare Diabetes Prevention Program expanded model. | |
| 42:3.0.1.1.11.10 | SUBPART J
| Subparts J-L [Reserved] | |
| 42:3.0.1.1.11.11 | SUBPART M
| Subpart M - Replacement and Reclamation of Medicare Payments | |
| 42:3.0.1.1.11.11.11.1 | SECTION 424.350
| 424.350 Replacement of checks that are lost, stolen, defaced, mutilated, destroyed, or paid on forged endorsements. | |
| 42:3.0.1.1.11.11.11.2 | SECTION 424.352
| 424.352 Intermediary and carrier checks that are lost, stolen, defaced, mutilated, destroyed or paid on forged endorsements. | |
| 42:3.0.1.1.11.12 | SUBPART N
| Subparts N-O [Reserved] | |
| 42:3.0.1.1.11.13 | SUBPART P
| Subpart P - Requirements for Establishing and Maintaining Medicare Billing Privileges | |
| 42:3.0.1.1.11.13.11.1 | SECTION 424.500
| 424.500 Scope. | |
| 42:3.0.1.1.11.13.11.2 | SECTION 424.502
| 424.502 Definitions. | |
| 42:3.0.1.1.11.13.11.3 | SECTION 424.505
| 424.505 Basic enrollment requirement. | |
| 42:3.0.1.1.11.13.11.4 | SECTION 424.506
| 424.506 National Provider Identifier (NPI) on all enrollment applications and claims. | |
| 42:3.0.1.1.11.13.11.5 | SECTION 424.507
| 424.507 Ordering covered items and services for Medicare beneficiaries. | |
| 42:3.0.1.1.11.13.11.6 | SECTION 424.510
| 424.510 Requirements for enrolling in the Medicare program. | |
| 42:3.0.1.1.11.13.11.7 | SECTION 424.514
| 424.514 Application fee. | |
| 42:3.0.1.1.11.13.11.8 | SECTION 424.515
| 424.515 Requirements for reporting changes and updates to, and the periodic revalidation of Medicare enrollment information. | |
| 42:3.0.1.1.11.13.11.9 | SECTION 424.516
| 424.516 Additional provider and supplier requirements for enrolling and maintaining active enrollment status in the Medicare program. | |
| 42:3.0.1.1.11.13.11.10 | SECTION 424.517
| 424.517 Onsite review. | |
| 42:3.0.1.1.11.13.11.11 | SECTION 424.518
| 424.518 Screening levels for Medicare providers and suppliers. | |
| 42:3.0.1.1.11.13.11.12 | SECTION 424.519
| 424.519 Disclosure of affiliations. | |
| 42:3.0.1.1.11.13.11.13 | SECTION 424.520
| 424.520 Effective date of Medicare billing privileges. | |
| 42:3.0.1.1.11.13.11.14 | SECTION 424.521
| 424.521 Request for payment by physicians, non-physician practitioners, physician and non-physician organizations, ambulance suppliers, opioid treatment programs, and home infusion therapy suppliers. | |
| 42:3.0.1.1.11.13.11.15 | SECTION 424.525
| 424.525 Rejection of a provider or supplier's enrollment application for Medicare enrollment. | |
| 42:3.0.1.1.11.13.11.16 | SECTION 424.530
| 424.530 Denial of enrollment in the Medicare program. | |
| 42:3.0.1.1.11.13.11.17 | SECTION 424.535
| 424.535 Revocation of enrollment in the Medicare program. | |
| 42:3.0.1.1.11.13.11.18 | SECTION 424.540
| 424.540 Deactivation of Medicare billing privileges. | |
| 42:3.0.1.1.11.13.11.19 | SECTION 424.545
| 424.545 Provider and supplier appeal rights. | |
| 42:3.0.1.1.11.13.11.20 | SECTION 424.550
| 424.550 Prohibitions on the sale or transfer of billing privileges. | |
| 42:3.0.1.1.11.13.11.21 | SECTION 424.555
| 424.555 Payment liability. | |
| 42:3.0.1.1.11.13.11.22 | SECTION 424.565
| 424.565 Overpayment. | |
| 42:3.0.1.1.11.13.11.23 | SECTION 424.570
| 424.570 Moratoria on newly enrolling Medicare providers and suppliers. | |