Part 419 — Prospective Payment Systems for Hospital Outpatient Department Services
Subpart A — General Provisions
Subpart B — Categories of Hospitals and Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System
Subpart C — Basic Methodology for Determining Prospective Payment Rates for Hospital Outpatient Services
Subpart D — Payments to Hospitals
- § 419.40— Payment concepts.
- § 419.41— Calculation of national beneficiary copayment amounts and national Medicare program payment amounts.
- § 419.42— Hospital election to reduce coinsurance.
- § 419.43— Adjustments to national program payment and beneficiary copayment amounts.
- § 419.44— Payment reductions for procedures.
- § 419.45— Payment and copayment reduction for devices replaced without cost or when full or partial credit is received.
- § 419.46— Requirements under the Hospital Outpatient Quality Reporting (OQR) Program.
- § 419.47— Coding and payment for Category B Investigational Device Exemption (IDE) studies.
- § 419.48— Definition of excepted items and services.
- § 419.49— Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99).
Subpart E — Updates
Subpart F — Limitations on Review
Subpart G — Transitional Pass-through Payments
Subpart H — Transitional Corridors
Subpart I — Prior Authorization for Outpatient Department Services
Subpart J — Payments to Rural Emergency Hospitals (REHs)
- § 419.90— Basis and scope of subpart.
- § 419.91— Definitions.
- § 419.92— Payment to rural emergency hospitals.
- § 419.93— Payment for an off-campus provider-based department of a rural emergency hospital.
- § 419.94— Preclusion of administrative and judicial review.
- § 419.95— Requirements under the Rural Emergency Hospital Quality Reporting (REHQR) Program.