42 C.F.R. § 421.3

Definitions.

Last amended: 2017Year: 2026Length: 118 wordsOfficial source

Cite as 42 C.F.R. § 421.3 (2026)

As used in this part— Intermediary means an entity that has a contract with CMS (under statutory provisions in effect prior to October 1, 2005) to determine and make Medicare payments for Part A or Part B benefits payable on a cost basis (or under the prospective payment system for hospitals) and to perform other related functions. For purposes of applying the performance criteria in § 421.120 and the performance standards in § 421.122 and any adverse action resulting from that application, the term “intermediary” also means a Blue Cross plan that has entered into a subcontract approved by CMS with the Blue Cross and Blue Shield Association to perform intermediary functions. [71 FR 68228, Nov. 24, 2006]
Cross-references to the CFR
421.120421.122
42 C.F.R. § 421.3: Definitions. | Justis AI