[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR411.9]



[Page 380]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 411_EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

--Table of Contents

 

    Subpart A_General Exclusions and Exclusion of Particular Services

 

Sec. 411.9  Services furnished outside the United States.



    (a) Basic rule. Except as specified in paragraph (b) of this 

section, Medicare does not pay for services furnished outside the United 

States. For purposes of this paragraph (a), the following rules apply:

    (1) The United States includes the 50 States, the District of 

Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, The 

Northern Mariana Islands, and for purposes of services rendered on board 

ship, the territorial waters adjoining the land areas of the United 

States.

    (2) Services furnished on board ship are considered to have been 

furnished in United States territorial waters if they were furnished 

while the ship was in a port of one of the jurisdictions listed in 

paragraph (a)(1) of this section, or within 6 hours before arrival at, 

or 6 hours after departure from, such a port.

    (3) A hospital that is not physically situated in one of the 

jurisdictions listed in paragraph (a)(1) of this section is considered 

to be outside the United States, even if it is owned or operated by the 

United States Government.

    (b) Exception. Under the circumstances specified in subpart H of 

part 424 of this chapter, payment may be made for covered inpatient 

services furnished in a foreign hospital and, on the basis of an 

itemized bill, for covered physicians' services and ambulance service 

furnished in connection with those inpatient services, but only for the 

period during which the inpatient hospital services are furnished.