42 C.F.R. § 424.109
Payment to the beneficiary.
Cite as 42 C.F.R. § 424.109 (2026)
Medicare pays the beneficiary for emergency services if the following conditions are met:
(a) The hospital does not have in effect an election to claim payment.
(b) The beneficiary, or someone on his or her behalf, submits—
(1) A claim that meets the requirements of § 424.32;
(2) An itemized hospital bill; and
(3) Evidence requested by CMS to establish that the services meet the requirements of this subpart.
- Cross-references to the CFR
- 424.32