[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

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

[CITE: 42CFR489.2]



[Page 934-935]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 489_PROVIDER AGREEMENTS AND SUPPLIER APPROVAL--Table of Contents

 

                      Subpart A_General Provisions

 

Sec. 489.2  Scope of part.



    (a) Subpart A of this part sets forth the basic requirements for 

submittal and acceptance of a provider agreement under Medicare. Subpart 

B of this part specifies the basic commitments and limitations that the 

provider must agree to as part of an agreement to provide services. 

Subpart C specifies the limitations on allowable charges to 

beneficiaries for deductibles, coinsurance, copayments, blood, and 

services that must be part of the provider agreement. Subpart D of this 

part specifies how incorrect collections are to be handled. Subpart F 

sets forth the circumstances and procedures for denial of payments for 

new admissions and for withholding of payment as an alternative to 

termination of a provider agreement.

    (b) The following providers are subject to the provisions of this 

part:

    (1) Hospitals.

    (2) Skilled nursing facilities (SNFs).



[[Page 935]]



    (3) Home health agencies (HHAs).

    (4) Clinics, rehabilitation agencies, and public health agencies.

    (5) Comprehensive outpatient rehabilitation facilities (CORFs).

    (6) Hospices.

    (7) Critical access hospital (CAHs).

    (8) Community mental health centers (CMHCs).

    (9) Religious nonmedical health care institutions (RNHCIs).

    (c)(1) Clinics, rehabilitation agencies, and public health agencies 

may enter into provider agreements only for furnishing outpatient 

physical therapy, and speech pathology services.

    (2) CMHCs may enter into provider agreements only to furnish partial 

hospitalization services.



[45 FR 22937, Apr. 4, 1980, as amended at 47 FR 56297, Dec. 15, 1982; 48 

FR 56036, Dec. 15, 1983; 51 FR 24492, July 3, 1986; 58 FR 30676, May 26, 

1993; 59 FR 6578, Feb. 11, 1994; 62 FR 46037, Aug. 29, 1997; 68 FR 

66720, Nov. 28, 2003]