Part 409 — Hospital Insurance Benefits
Subpart A — Hospital Insurance Benefits: General Provisions
Subpart B — Inpatient Hospital Services and Inpatient Critical Access Hospital Services
- § 409.10— Included services.
- § 409.11— Bed and board.
- § 409.12— Nursing and related services, medical social services; use of hospital or CAH facilities.
- § 409.13— Drugs and biologicals.
- § 409.14— Supplies, appliances, and equipment.
- § 409.15— Services furnished by an intern or a resident-in-training.
- § 409.16— Other diagnostic or therapeutic services.
- § 409.17— Physical therapy, occupational therapy, and speech-language pathology services.
- § 409.18— Services related to kidney transplantations.
Subpart C — Posthospital SNF Care
- § 409.20— Coverage of services.
- § 409.21— Nursing care.
- § 409.22— Bed and board.
- § 409.23— Physical therapy, occupational therapy, and speech-language pathology services.
- § 409.24— Medical social services.
- § 409.25— Drugs, biologicals, supplies, appliances, and equipment.
- § 409.26— Transfer agreement hospital services.
- § 409.27— Other services generally provided by (or under arrangements made by) SNFs.
Subpart D — Requirements for Coverage of Posthospital SNF Care
- § 409.30— Basic requirements.
- § 409.31— Level of care requirement.
- § 409.32— Criteria for skilled services and the need for skilled services.
- § 409.33— Examples of skilled nursing and rehabilitation services.
- § 409.34— Criteria for “daily basis”.
- § 409.35— Criteria for “practical matter”.
- § 409.36— Effect of discharge from posthospital SNF care.
Subpart E — Home Health Services Under Hospital Insurance
- § 409.40— Basis, purpose, and scope.
- § 409.41— Requirement for payment.
- § 409.42— Beneficiary qualifications for coverage of services.
- § 409.43— Plan of care requirements.
- § 409.44— Skilled services requirements.
- § 409.45— Dependent services requirements.
- § 409.46— Allowable administrative costs.
- § 409.47— Place of service requirements.
- § 409.48— Visits.
- § 409.49— Excluded services.
- § 409.50— Coinsurance for durable medical equipment (DME) and applicable disposable devices furnished as a home health service.
Subpart F — Scope of Hospital Insurance Benefits
- § 409.60— Benefit periods.
- § 409.61— General limitations on amount of benefits.
- § 409.62— Lifetime maximum on inpatient psychiatric care.
- § 409.63— Reduction of inpatient psychiatric benefit days available in the initial benefit period.
- § 409.64— Services that are counted toward allowable amounts.
- § 409.65— Lifetime reserve days.
- § 409.66— Revocation of election not to use lifetime reserve days.
- § 409.68— Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits.
Subpart G — Hospital Insurance Deductibles and Coinsurance
- § 409.80— Inpatient deductible and coinsurance: General provisions.
- § 409.82— Inpatient hospital deductible.
- § 409.83— Inpatient hospital coinsurance.
- § 409.85— Skilled nursing facility (SNF) care coinsurance.
- § 409.87— Blood deductible.
- § 409.89— Exemption of kidney donors from deductible and coinsurance requirements.