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Medicare A Hospital & B Doctor Visits
Technical Codes
Part A—Hospital Insurance Benefits
for the Aged and Disabled
Sec. 1811. Description of program
Sec. 1813. Deductibles and coinsurance
Sec. 1814. Conditions of and limitations on payment for services
Sec. 1815. Payment to providers of services
Sec. 1816. Provisions relating to the administration of Part A
Sec. 1817. Federal hospital insurance trust fund
Sec. 1818. Hospital insurance benefits for uninsured elderly individuals not otherwise eligible
Sec. 1819. Requirements for, and assuring quality of care in, skilled nursing facilities
Sec. 1820. Medicare rural hospital flexibility program
Sec. 1821. Conditions for coverage of religious nonmedical health care institutional services
Part B—Supplementary Medical – Doctor Visits
Insurance Benefits for the Aged and Disabled
Sec. 1831. Establishment of supplementary medical insurance program for the aged and the disabled
Sec. 1833. Payment of benefits
Sec. 1834. Special payment rules for particular items and services
Sec. 1834A. IMPROVING POLICIES FOR CLINICAL DIAGNOSTIC LABORATORY TESTS
Sec. 1835. Procedure for payment of claims of providers of services
Sec. 1836. Eligible individuals
Sec. 1839. Amounts of premiums
Sec. 1840. Payment of premiums
Sec. 1841. Federal supplementary medical insurance trust fund
Sec. 1842. Provisions relating to the administration of Part B
Sec. 1843. State agreements for coverage of eligible individuals who are receiving money payments under public assistance programs or are eligible for medical assistance Sec. 1844. Appropriations to cover Government contributions and contingency reserve
Sec. 1846. Intermediate sanctions for providers or suppliers of clinical diagnostic laboratory tests
Sec. 1847. Competitive acquisition of certain items and services
Sec. 1847A. Use of average sales price payment methodology
Sec. 1847B. Competitive acquisition of outpatient drugs and biologicals
Sec. 1848. Payment for physicians’ services
Part C—MEDICARE+CHOICE PROGRAM
Medicare Advantage
Sec. 1851. Eligibility, election, and enrollment
Sec. 1852. Benefits and beneficiary protections
Sec. 1853. Payments to Medicare+Choice organizations
Sec. 1854. Premiums and Premium Amounts
Sec. 1856. Establishment of standards
Sec. 1857. Contracts with Medicare+Choice organizations
Sec. 1858. Special Rules for MA Regional Plans
Sec. 1859. Definitions; miscellaneous provisions
Part D—Voluntary Prescription Drug Benefit Program
Subpart 1—Part D Eligible Individuals and Prescription Drug Benefits
Sec. 1860D-1. Eligibility, enrollment, and information
Sec. 1860D-2. Prescription drug benefits
Sec. 1860D-3. Access to a choice of qualified prescription drug coverage
Sec. 1860D-4. Beneficiary protections for qualified prescription drug coverage
Subpart 2—Prescription Drug Plans; PDP Sponsors; Financing
Sec. 1860D-11. PDP regions; submission of bids; plan approval
Sec. 1860D-12. Requirements for and contracts with prescription drug plan (PDP) sponsors
Sec. 1860D-13. Premiums; late enrollment penalty
Sec. 1860D-14. Premium and cost-sharing subsidies for low-income individuals
Sec. 1860D-14A. Medicare coverage gap discount program
Sec. 1860D-15. Subsidies for Part D eligible individuals for qualified prescription drug coverage
Subpart 3—Application to Medicare Advantage Program and Treatment of Employer-Sponsored Programs and Other Prescription Drug Plans
Sec. 1860D-21. Application to medicare advantage program and related managed care programs
Sec. 1860D-22. Special rules for employer-sponsored programs
Sec. 1860D-23. State pharmaceutical assistance programs
Sec. 1860D-24. Coordination requirements for plans providing prescription drug coverage
Subpart 4—Medicare Prescription Drug Discount Card and Transitional Assistance Program
Sec. 1860D-31. Medicare prescription drug discount card and transitional assistance program
Subpart 5—Definitions and Miscellaneous Provisions
Sec. 1860D-41. Definitions; treatment of references to provisions in Part C
Sec. 1860D-42. Miscellaneous provisions
Sec. 1860D-43 . Condition for Coverage of Drugs Under This Part
Part E—Miscellaneous Provisions
Sec. 1861. Definitions of services, institutions, etc.
Sec. 1862. Exclusions from coverage and medicare as secondary payer
Sec. 1865. Effect of accreditation
Sec. 1866. Agreements with providers of services; enrollment processes
Sec. 1866A. Demonstration of application of physician volume increases to group practices
Sec. 1866B. Provisions for administration of demonstration program
Sec. 1866C. Health care quality demonstration program
Sec. 1866D. National pilot program on payment bundling
Sec. 1866E. Independence at home medical practice demonstration program
Sec. 1867. Examination and treatment for emergency medical conditions and women in labor
Sec. 1868. Practicing physicians advisory council; council for technology and innovation
Sec. 1869. Determinations; Appeals
Sec. 1872. Application of certain provisions of Title II
Sec. 1873. Designation of organization or publication by name
Sec. 1874A. Contracts with medicare administrative contractors
Sec. 1875. Studies and recommendations
Sec. 1876. Payments to health maintenance organizations and competitive medical plans
Sec. 1877. Limitation on certain physician referrals
Sec. 1878. Provider reimbursement review board
Sec. 1879. Limitation on liability of beneficiary where medicare claims are disallowed
Sec. 1880. Indian health service facilities
Sec. 1881. Medicare coverage for end stage renal disease patients
Sec. 1881A. Medicare coverage for individuals exposed to environmental health hazards
Sec. 1882. Certification of medicare supplemental health insurance policies
Sec. 1883. Hospital providers of extended care services
Sec. 1884. Payments to promote closing and conversion of underutilized hospital facilities
Sec. 1885. Withholding of payments for certain medicaid providers
Sec. 1886. Payment to hospitals for inpatient hospital services
Sec. 1887. Payment of provider–based physicians and payment under certain percentage arrangements
Sec. 1888. Payment to skilled nursing facilities for routine service costs
Sec. 1889. Provider education and technical assistance
Sec. 1890. Contract with a consensus-based entity regarding performance measurement
Sec. 1890A. Quality and efficiency measurement
Sec. 1891. Conditions of participation for home health agencies; Home health quality
Sec. 1893. Medicare integrity program
Sec. 1895. Prospective payment for home health services
Sec. 1896. Medicare subvention for military retirees
Sec. 1897. Health care infrastructure improvement program
Sec. 1898. medicare improvement fund
Sec. 1899. Shared savings program
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