C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS › Subpart E—Community Mental Health Centers (CMHCs) Providing Partial Hospitalization Services and Intensive Outpatient Services

42 C.F.R. § 410.110

Requirements for coverage of partial hospitalization services by CMHCs

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Medicare part B covers partial hospitalization services furnished by or under arrangements made by a CMHC if they are provided by a CMHC as defined in § 410.2 that has in effect a provider agreement under part 489 of this chapter and if the services are—

(a) Prescribed by a physician and furnished under the general supervision of a physician;

(b) Subject to certification by a physician in accordance with § 424.24(e)(1) of this subchapter; and

(c) Furnished under a plan of treatment that meets the requirements of § 424.24(e)(2) of this subchapter.

[59 FR 6577, Feb. 11, 1994]
Notes of Decisions
Cited in 1 case, 2004–2004 · leading case: Hosp. Serv. Dist. No. 1 of the Par. of Lafourche v. Thompson, 343 F. Supp. 2d 518 (E.D. La. 2004).
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Hosp. Serv. Dist. No. 1 of the Par. of Lafourche v. Thompson, 343 F. Supp. 2d 518 (E.D. La. 2004). “As such, this constituted grounds for a technical denial of the beneficiaries’ claims.”
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