StacksVerified U.S. regulatory reference

42 CFR §405.920

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov
After a claim is filed with the appropriate contractor in the manner and form described in subpart C of part 424 of this chapter, the contractor must—
  1. (a)Determine if the items and services furnished are covered or otherwise reimbursable under title XVIII of the Act;
  2. (b)Determine any amounts payable and make payment accordingly; and
  3. (c)Notify the parties to the initial determination of the determination in accordance with § 405.921.