[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: 42CFR412.6]



[Page 460-461]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 412_PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES

--Table of Contents

 

                      Subpart A_General Provisions

 

Sec. 412.6  Cost reporting periods subject to the prospective payment 

systems.



    (a) Initial cost reporting period for each prospective payment 

system. (1) Each subject hospital is paid under the prospective payment 

system for operating costs for inpatient hospital services effective 

with the hospital's first cost reporting period beginning on or after 

October 1, 1983 and for inpatient capital-related costs effective with 

the hospital's first cost reporting period beginning on or after October 

1, 1991.

    (2) The hospital is paid the applicable prospective payment rate for 

inpatient operating costs and capital-related costs for each discharge 

occurring on or after the first day of its first cost reporting period 

subject to the applicable prospective payment system.

    (3) If a discharged beneficiary was admitted to the hospital before 

the first day of the hospital's first cost reporting period subject to 

the prospective payment system for inpatient operating costs, the 

reasonable costs of services furnished before that day are paid under 

the cost reimbursement provisions of part 413 of this chapter. For such 

discharges, the amount otherwise payable under the applicable 

prospective payment rate is reduced by the amount paid on a reasonable 

cost basis for inpatient hospital services furnished to that beneficiary 

during the hospital stay. If the amount paid under reasonable cost 

exceeds the inpatient operating prospective payment amount, the 

reduction is limited to the inpatient operating prospective payment 

amount.

    (b) Changes in cost reporting periods. CMS recognizes a change in a 

hospital's cost reporting period made after November 30, 1982 only if 

the change



[[Page 461]]



has been requested in writing by the hospital and approved by the 

intermediary in accordance with Sec. 413.24(f)(3) of this chapter.



[57 FR 39819, Sept. 1, 1992]