2005 CFR Title 42, Volume 2

Title 42--Public Health CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
	414.1	Basis and scope.
	414.2	Definitions.
	414.4	Fee schedule areas.
	414.20	Formula for computing fee schedule amounts.
	414.21	Medicare payment basis.
	414.22	Relative value units (RVUs).
	414.24	Review, revision, and addition of RVUs for physician services.
	414.26	Determining the GAF.
	414.28	Conversion factors.
	414.30	Conversion factor update.
	414.32	Determining payments for certain physicians' services furnished in facility settings.
	414.34	Payment for services and supplies incident to a physician's service.
	414.36	Payment for drugs incident to a physician's service.
	414.39	Special rules for payment of care plan oversight.
	414.40	Coding and ancillary policies.
	414.42	Adjustment for first 4 years of practice.
	414.44	Transition rules.
	414.46	Additional rules for payment of anesthesia services.
	414.48	Limits on actual charges of nonparticipating suppliers.
	414.50	Physician billing for purchased diagnostic tests.
	414.52	Payment for physician assistants' services.
	414.54	Payment for certified nurse-midwives' services.
	414.56	Payment for nurse practitioners' and clinical nurse specialists' services.
	414.58	Payment of charges for physician services to patients in providers.
	414.60	Payment for the services of CRNAs.
	414.62	Fee schedule for clinical psychologist services.
	414.63	Payment for outpatient diabetes self-management training.
	414.64	Payment for medical nutrition therapy.
	414.65	Payment for telehealth services.
	414.66	Incentive payments for physician scarcity areas.
	414.67	Incentive payments for Health Professional Shortage Areas.
	414.100	Purpose.
	414.102	General payment rules.
	414.104	PEN Items and Services.
	414.200	Purpose.
	414.202	Definitions.
	414.210	General payment rules.
	414.220	Inexpensive or routinely purchased items.
	414.222	Items requiring frequent and substantial servicing.
	414.224	Customized items.
	414.226	Oxygen and oxygen equipment.
	414.228	Prosthetic and orthotic devices.
	414.229	Other durable medical equipment--capped rental items.
	414.230	Determining a period of continuous use.
	414.232	Special payment rules for transcutaneous electrical nerve stimulators (TENS).
	414.300	Scope of subpart.
	414.310	Determination of reasonable charges for physician services furnished to renal dialysis patients.
	414.313	Initial method of payment.
	414.314	Monthly capitation payment method.
	414.316	Payment for physician services to patients in training for self-dialysis and home dialysis.
	414.320	Determination of reasonable charges for physician renal transplantation services.
	414.330	Payment for home dialysis equipment, supplies, and support services.
	414.335	Payment for EPO furnished to a home dialysis patient for use in the home.
	414.601	Purpose.
	414.605	Definitions.
	414.610	Basis of payment.
	414.615	Transition to the ambulance fee schedule.
	414.617	Transition from regional to national ambulance fee schedule.
	414.620	Publication of the ambulance fee schedule.
	414.625	Limitation on review.
	414.701	Purpose.
	414.704	Definitions.
	414.707	Basis of payment.
	414.800	Purpose.
	414.802	Definitions.
	414.804	Basis of payment.
	414.806	Penalties associated with the failure to submit timely and accurate ASP data.
	414.900	Basis and scope.
	414.902	Definitions.
	414.904	Average sales price as the basis for payment.
	414.906	Competitive acquisition program as the basis for payment.
	414.908	Competitive acquisition program.
	414.910	Bidding process.
	414.912	Conflicts of interest
	414.914	Terms of contract.
	414.916	Dispute resolution for vendors and beneficiaries.
	414.917	Dispute resolution and process for suspension or termination of approved CAP contract.
	414.918	Assignment.
	414.920	Judicial review.
	414.1000	Purpose.
	414.1001	Basis of payment.