C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 409—HOSPITAL INSURANCE BENEFITS › Subpart G—Hospital Insurance Deductibles and Coinsurance

42 C.F.R. § 409.82

Inpatient hospital deductible

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(a) General provisions—(1) The inpatient hospital deductible is a fixed amount chargeable to the beneficiary when he or she receives covered services in a hospital or a CAH for the first time in a benefit period.

(2) Although the beneficiary may be hospitalized several times during a benefit period, the deductible is charged only once during that period. If the beneficiary begins more than one benefit period in the same year, a deductible is charged for each of those periods.

(3) For services furnished before January 1, 1982, the applicable deductible is the one in effect when the benefit period began.

(4) For services furnished after December 31, 1981, the applicable deductible is the one in effect during the calendar year in which the services were furnished.

(b) Specific deductible amounts. The specific deductible amounts for each calendar year are published in the Federal Register no later than October 1 of the preceding year.

(c) Exception to published amounts. If the total hospital or CAH charge is less than the deductible amount applicable for the calendar year in which the services were furnished, the amount of the charge is the deductible for the year.

[48 FR 12541, Mar. 25, 1983, as amended at 54 FR 4026, Jan. 27, 1989; 58 FR 30666, 30667, May 26, 1993]
Notes of Decisions
Cited in 3 cases (2 in the last 5 years), 2008–2021 · leading case: New LifeCare Hospitals v. Xavier Becerra, 7 F.4th 1215 (D.C. Cir. 2021).
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New LifeCare Hospitals v. Xavier Becerra, 7 F.4th 1215 (D.C. Cir. 2021). “§ 1395e; 42 C.F.R. §§ 409.82 , 409.83. 3 This case concerns several hospitals that treat “dual- eligible” patients—i.”
Detroit Receiving Hosp. v. Leavitt, 561 F. Supp. 2d 795 (E.D. Mich. 2008). “42 C.F.R. § 409.82 . The Medicare copayment, also called coinsurance, is the amount that a beneficiary must pay for certain treatment after Medicare coverage becomes effective.”
Select Specialty Hosp. - Denver, Inc. v. Sebelius (D.D.C. 2021). “§ 1395e; 42 C.F.R. §§ 409.82 , 409.83. Individuals eligible for both Medicare and Medicaid (“dual-eligible patients”), however, often lack the financial means “to afford the coinsurances and deductibles required of them under Medicare.”
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