C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES › Subpart C—Fee Schedules for Parenteral and Enteral Nutrition (PEN) Nutrients, Equipment and Supplies, Splints, Casts, and Certain Intraocular Lenses (IOLs)

42 C.F.R. § 414.104

PEN Items and Services

Read at: eCFRecfr.gov CornellLII GovInfogovinfo.gov CasesGoogle Scholar

(a) Payment rules. Payment for PEN items and services is made in a lump sum for nutrients and supplies that are purchased and on a monthly basis for equipment that is rented.

(b) Fee schedule amount. The fee schedule amount for payment for an item or service furnished in 2002 is the lesser of—

(i) The reasonable charge from 1995; or

(ii) The reasonable charge that would have been used in determining payment for 2002.

Notes of Decisions
Cited in 1 case (1 in the last 5 years), 2022–2022 · leading case: Waters v. Sec'y of Health & Human Servs. (W.D. Mich. 2022).
Sort: Relevance Newest Treatment
Waters v. Sec'y of Health & Human Servs. (W.D. Mich. 2022). “” 42 C.F.R. § 414.104 (a). This provision thus makes clear that enteral nutrition is covered when used in conjunction with a prosthetic device, but payment for the liquid nutrients is made in a different manner for the equipment used to administer the nutrition.”
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.