StacksVerified U.S. regulatory reference

42 CFR §419.21

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
Except for services described in § 419.22, effective for services furnished on or after July 1, 2000, payment is made under the hospital outpatient prospective payment system for the following:
  1. (a)Medicare Part B services furnished to hospital outpatients designated by the Secretary under this part.
  2. (b)Services designated by the Secretary that are covered under Medicare Part B when furnished to hospital inpatients who are either not entitled to benefits under Part A or who have exhausted their Part A benefits but are entitled to benefits under Part B of the program.
  3. (c)Partial hospitalization services and intensive outpatient services furnished by community mental health centers (CMHCs).
  4. (d)The following medical and other health services furnished by a home health agency (HHA) to patients who are not under an HHA plan or treatment or by a hospice program furnishing services to patients outside the hospice benefit:
    1. (1)Antigens.
    2. (2)Splints and casts.
    3. (3)Hepatitis B vaccine.
  5. (e)
    1. (1)Effective January 1, 2005 through December 31, 2008, an initial preventive physical examination, as defined in § 410.16 of this chapter, if the examination is performed no later than 6 months after the individual's initial Part B coverage date that begins on or after January 1, 2005.
    2. (2)Effective January 1, 2009, an initial preventive physical examination, as defined in § 410.16 of this chapter, if the examination is performed no later than 12 months after the date of the individual's initial enrollment in Part B.