[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR1000.20]



[Page 1120]

 

                         TITLE 42--PUBLIC HEALTH

 

      GENERAL--HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

PART 1000_INTRODUCTION; GENERAL DEFINITIONS--Table of Contents

 

                          Subpart B_Definitions

 

Sec.  1000.20  Definitions specific to Medicare.



    As used in connection with the Medicare program, unless the context 

indicates otherwise--

    Carrier means an entity that has a contract with CMS to determine 

and make Medicare payments for Part B benefits payable on a charge basis 

and to perform other related functions.

    Entitled means that an individual meets all the requirements for 

Medicare benefits.

    Hospital insurance benefits means payments on behalf of, and in rare 

circumstances directly to, an entitled individual for services that are 

covered under Part A of Title XVIII of the Act.

    Intermediary means an entity that has a contract with CMS to 

determine and make Medicare payments for Part A or Part B benefits 

payable on a cost basis and to perform other related functions.

    Medicare Part A means the hospital insurance program authorized 

under Part A of Title XVIII of the Act.

    Medicare Part B means the supplementary medical insurance program 

authorized under Part B of Title XVIII of the Act.

    Provider means a hospital, a skilled nursing facility, a 

comprehensive outpatient rehabilitation facility, a home health agency, 

or effective November 1, 1983 through September 30, 1986, a hospice that 

has in effect an agreement to participate in Medicare, or a clinic, a 

rehabilitation agency, or a public health agency that has a similar 

agreement but only to furnish outpatient physical therapy or speech 

pathology services.

    Railroad retirement benefits means monthly benefits payable to 

individuals under the Railroad Retirement Act of 1974 (45 U.S.C. 

beginning at section 231).

    Services means medical care or services and items, such as medical 

diagnosis and treatment, drugs and biologicals, supplies, appliances, 

and equipment, medical social services, and use of hospital or SNF 

facilities.

    Supplementary medical insurance benefits means payment to or on 

behalf of an entitled individual for services covered under Part B of 

Title XVIII of the Act.

    Supplier means a physician or other practitioner, or an entity other 

than a provider, that furnishes health care services under Medicare.



[51 FR 34766, Sept. 30, 1986, as amended at 57 FR 3329, Jan. 29, 1992]