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42 CFR Chapter IV

Chapter IV—Centers for Medicare & Medicaid Services, Department of Health and Human Services

2,458,318 words

68 parts

42 CFR Chapter IV
Official text on eCFR ↗

Agencies with references in this chapter

Parts

Subchapter A — Subchapter A—General Provisions

Part Heading Sections Words
400 Part 400—Introduction; Definitions 3 2,006
401 Part 401—General Administrative Requirements 50 17,459
402 Part 402—Civil Money Penalties, Assessments, and Exclusions 29 12,715
403 Part 403—Special Programs and Projects 87 35,450

Subchapter B — Subchapter B—Medicare Program

Part Heading Sections Words
405 Part 405—Federal Health Insurance for the Aged and Disabled 272 130,338
406 Part 406—Hospital Insurance Eligibility and Entitlement 25 11,649
407 Part 407—Supplementary Medical Insurance (SMI) Enrollment and Entitlement 28 8,488
408 Part 408—Premiums for Supplementary Medical Insurance 50 10,161
409 Part 409—Hospital Insurance Benefits 55 17,422
410 Part 410—Supplementary Medical Insurance (SMI) Benefits 96 57,382
411 Part 411—Exclusions from Medicare and Limitations on Medicare Payment 94 63,783
412 Part 412—Prospective Payment Systems for Inpatient Hospital Services 186 142,904
413 Part 413—Principles of Reasonable Cost Reimbursement; Payment for End-Stage Renal Disease Services; Prospectively Determined Payment Rates for Skilled Nursing Facilities; Payment for Acute Kidney Injury Dialysis 124 133,365
414 Part 414—Payment for Part B Medical and Other Health Services 198 148,132
415 Part 415—Services Furnished by Physicians in Providers, Supervising Physicians in Teaching Settings, and Residents in Certain Settings 30 11,227
416 Part 416—Ambulatory Surgical Services 54 16,317
417 Part 417—Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans 148 48,300
418 Part 418—Hospice Care 51 28,661
419 Part 419—Prospective Payment Systems for Hospital Outpatient Department Services 36 18,987
420 Part 420—Program Integrity: Medicare 17 6,033
421 Part 421—Medicare Contracting 33 7,801
422 Part 422—Medicare Advantage Program 277 170,379
423 Part 423—Voluntary Medicare Prescription Drug Benefit 337 185,770
424 Part 424—Conditions for Medicare Payment 99 61,538
425 Part 425—Medicare Shared Savings Program 94 86,474
426 Part 426—Review of National Coverage Determinations and Local Coverage Determinations 82 15,309
427 Part 427—Medicare Part B Drug Inflation Rebate Program 21 11,033
428 Part 428—Medicare Part D Drug Inflation Rebate Program 20 11,207
429 [Reserved] 0 0

Subchapter C — Subchapter C—Medical Assistance Programs

Part Heading Sections Words
430 Part 430—Grants to States for Medical Assistance Programs 43 13,692
431 Part 431—State Organization and General Administration 120 34,422
432 Part 432—State Personnel Administration 9 2,224
433 Part 433—State Fiscal Administration 67 28,782
434 Part 434—Contracts 11 1,240
435 Part 435—Eligibility in the States, District of Columbia, the Northern Mariana Islands, and American Samoa 173 63,034
436 Part 436—Eligibility in Guam, Puerto Rico, and the Virgin Islands 78 18,201
437 Part 437—Medicaid Quality 5 2,507
438 Part 438—Managed Care 106 66,002
440 Part 440—Services: General Provisions 62 19,082
441 Part 441—Services: Requirements and Limits Applicable to Specific Services 140 48,850
442 Part 442—Standards for Payment to Nursing Facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities 20 4,050
447 Part 447—Payments for Services 72 37,655
455 Part 455—Program Integrity: Medicaid 60 13,100
456 Part 456—Utilization Control 142 17,628

Subchapter D — Subchapter D—State Children's Health Insurance Programs (SCHIPs)

Part Heading Sections Words
457 Part 457—Allotments and Grants to States 162 47,665

Subchapter E — Subchapter E—Programs of All-Inclusive Care for the Elderly (PACE)

Part Heading Sections Words
460 Part 460—Programs of All-Inclusive Care for the Elderly (PACE) 91 26,598

Subchapter F — Subchapter F—Quality Improvement Organizations

Part Heading Sections Words
475 Part 475—Quality Improvement Organizations 9 1,397
476 Part 476—Quality Improvement Organization Review 29 11,111
478 Part 478—Reconsiderations and Appeals 21 3,079
480 Part 480—Acquisition, Protection, and Disclosure of Quality Improvement Organization Information 33 6,144
481 [Reserved] 0 0

Subchapter G — Subchapter G—Standards and Certification

Part Heading Sections Words
482 Part 482—Conditions of Participation for Hospitals 46 28,035
483 Part 483—Requirements for States and Long Term Care Facilities 82 59,652
484 Part 484—Home Health Services 47 23,578
485 Part 485—Conditions of Participation: Specialized Providers 85 47,661
486 Part 486—Conditions for Coverage of Specialized Services Furnished by Suppliers 34 13,639
488 Part 488—Survey, Certification, and Enforcement Procedures 148 57,943
489 Part 489—Provider Agreements and Supplier Approval 49 20,711
491 Part 491—Certification of Certain Health Facilities 12 4,188
493 Part 493—Laboratory Requirements 220 60,494
494 Part 494—Conditions for Coverage for End-Stage Renal Disease Facilities 20 11,100
495 Part 495—Standards for the Electronic Health Record Technology Incentive Program 58 63,216
498 Part 498—Appeals Procedures for Determinations That Affect Participation in the Medicare Program and for Determinations That Affect the Participation of ICFs/IID and Certain NFs in the Medicaid Program 56 10,092

Subchapter H — Subchapter H—Health Care Infrastructure and Model Programs

Part Heading Sections Words
505 Part 505—Establishment of the Health Care Infrastructure Improvement Program 10 2,078
510 Part 510—Comprehensive Care for Joint Replacement Model 31 23,511
512 Part 512—Standard Provisions for Mandatory Innovation Center Models and Specific Provisions for Certain Models 132 83,029

Subchapter I — Subchapter I—Basic Health Program

Part Heading Sections Words
600 Part 600—Administration, Eligibility, Essential Health Benefits, Performance Standards, Service Delivery Requirements, Premium and Cost Sharing, Allotments, and Reconcilation 49 12,638
601-699 [Reserved] 0 0