Source: http://www.law.cornell.edu/cfr/text/42/412.88
Timestamp: 2014-12-26 07:25:52
Document Index: 790569564

Matched Legal Cases: ['art 412', '§ 412', '§ 412', '§ 412', '§ 412', '§ 412', '§ 412', '§ 412']

42 CFR 412.88 - Additional payment for new medical service or technology. | LII / Legal Information Institute
CFR › Title 42 › Chapter IV › Subchapter B › Part 412 › Subpart F › Section 412.88 42 CFR 412.88 - Additional payment for new medical service or technology.
§ 412.88
For discharges involving new medical services or technologies that meet the criteria specified in § 412.87, Medicare payment will be:
The full DRG payment (including adjustments for indirect medical education and disproportionate share but excluding outlier payments);
The payment determined under § 412.4(f) for transfer cases;
The payment determined under § 412.92(d) for sole community hospitals; or
The payment determined under § 412.108(c) for Medicare-dependent hospitals; plus
If the costs of the discharge (determined by applying the operating cost to charge ratios as described in § 412.84(h)) exceed the full DRG payment, an additional amount equal to the lesser of—
50 percent of the costs of the new medical service or technology; or
50 percent of the amount by which the costs of the case exceed the standard DRG payment.
Unless a discharge case qualifies for outlier payment under § 412.84, Medicare will not pay any additional amount beyond the DRG payment plus 50 percent of the estimated costs of the new medical service or technology.
[66 FR 46924, Sept. 7, 2001, as amended at 67 FR 50111, Aug. 1, 2002; 69 FR 49244, Aug. 11, 2004; 72 FR 47411, Aug. 22, 2007]