US · guidance
CMS Pub. 100-02, ch. 6, § 20.1.1
General Rule
Except as provided in section 20.1.2 of this chapter, Medicare Part B does not pay for any
item or service that is furnished to a hospital outpatient, as defined in section 20.2, during
an encounter, as defined in section 20.3, by an entity other than the hospital unless the
hospital has arrangements with that entity to furnish that particular service to its patients.
The arrangements must provide that Medicare payment made to the hospital that arranged
for the services discharges the liability of the beneficiary or any other person to pay for
those services. See the Medicare General Information, Eligibility, and Entitlement
Manual, Pub.100-01, chapter 5, section 10.3 for the definition of “arrangements.” For the
purposes of this section, the term “hospital” includes a Critical Access Hospital (CAH).
History
(Rev. 82; Issued: 02-08-08; Effective: 01-01-08; Implementation: 03-10-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
d98eb2ee7e90eafb12d882ffeba746a63f0db5403152227c32e0efb8fab6311e
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