42 C.F.R. § 424.126
Payment to the hospital.
Cite as 42 C.F.R. § 424.126 (2026)
(a)
Conditions for payment.
Medicare pays the hospital if it—
(1) Has in effect an election that—
(i) Meets the requirements set forth in § 424.104; and
(ii) Reflects the hospital's intent to claim for all covered services furnished during a calendar year.
(2) Claims payment in accordance with §§ 424.32 and 413.74 of this chapter; and
(3) Submits evidence requested by CMS to establish that the services meet the requirements of this subpart.
(b)
Amount of payment.
Payment is made (in accordance with § 413.74 of this chapter) on the basis of 100 percent of the hospital's customary charges, subject to the applicable deductible and coinsurance provisions set forth elsewhere in this chapter.
- Cross-references to the CFR
- 413.74424.104424.32