Home/CFR/Title 42/Part 419
FEDERAL · 42 CFR

Part 419 — Prospective Payment Systems for Hospital Outpatient Department Services

36 sections · Title 42: Public Health

§ 419.1Basis and scope.
§ 419.2Basis of payment.
§ 419.20Hospitals subject to the hospital outpatient prospective payment system.
§ 419.21Hospital services subject to the outpatient prospective payment system.
§ 419.22Hospital services excluded from payment under the hospital outpatient prospective payment system.
§ 419.30Base expenditure target for calendar year 1999.
§ 419.31Ambulatory payment classification (APC) system and payment weights.
§ 419.32Calculation of prospective payment rates for hospital outpatient services.
§ 419.40Payment concepts.
§ 419.41Calculation of national beneficiary copayment amounts and national Medicare program payment amounts.
§ 419.42Hospital election to reduce coinsurance.
§ 419.43Adjustments to national program payment and beneficiary copayment amounts.
§ 419.44Payment reductions for procedures.
§ 419.45Payment and copayment reduction for devices replaced without cost or when full or partial credit is received.
§ 419.46Requirements under the Hospital Outpatient Quality Reporting (OQR) Program.
§ 419.47Coding and payment for Category B Investigational Device Exemption (IDE) studies.
§ 419.48Definition of excepted items and services.
§ 419.49Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99).
§ 419.50Annual review.
§ 419.60Limitations on administrative and judicial review.
§ 419.62Transitional pass-through payments: General rules.
§ 419.64Transitional pass-through payments: Drugs and biologicals.
§ 419.66Transitional pass-through payments: Medical devices.
§ 419.70Transitional adjustments to limit decline in payments.
§ 419.71Payment reduction for certain X-ray imaging services.
§ 419.80Basis and scope of this subpart.
§ 419.81Definitions.
§ 419.82Prior authorization for certain covered hospital outpatient department services.
§ 419.83List of hospital outpatient department services requiring prior authorization.
§ 419.84-419.89§§ 419.84-419.89 [Reserved]
§ 419.90Basis and scope of subpart.
§ 419.91Definitions.
§ 419.92Payment to rural emergency hospitals.
§ 419.93Payment for an off-campus provider-based department of a rural emergency hospital.
§ 419.94Preclusion of administrative and judicial review.
§ 419.95Requirements under the Rural Emergency Hospital Quality Reporting (REHQR) Program.