42 CFR §512.535
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Episodes tested in TEAM include only those in which care is furnished to beneficiaries who meet all of the following criteria upon admission for an anchor procedure or anchor hospitalization:
- (1)Are enrolled in Medicare Parts A and B.
- (2)Are not eligible for Medicare on the basis of having end stage renal disease, as described in § 406.13 of this chapter.
- (3)Are not enrolled in any managed care plan (for example, Medicare Advantage, health care prepayment plans, or cost-based health maintenance organizations).
- (4)Are not covered under a United Mine Workers of America health care plan.
- (5)Have Medicare as their primary payer.
- (b)The episode is canceled in accordance with § 512.537(b) if at any time during the episode a beneficiary no longer meets all criteria in this section.