Code of Federal Regulations (alpha)

CFR /  Title 42  /  Part 424  /  Sec. 424.124 Conditions for payment for physician services and

(a) Basic rules. Medicare Part B pays for physician and ambulance services if--

(1) They are furnished--

(i) To an individual who is entitled to Part B benefits; and

(ii) In connection with covered inpatient hospital services; and

(2) They meet the conditions set forth in paragraphs (b) and (c) of this section.

(b) Physician services. (1) The physician services are services covered under Medicare Part B and are furnished--

(1) The physician services are services covered under Medicare Part B and are furnished--

(i) In the hospital, during a period of covered inpatient services; or

(ii) Outside the hospital, on the day of admission and for the same condition that required inpatient admission; and

(2) The physician is legally authorized to practice in the country where he or she furnishes the services.

(c) Ambulance services. The ambulance services are--

(1) Necessary because the use of other means of transportation is contraindicated by the beneficiary's condition; and

(2) Furnished by an ambulance that meets the definition in Sec. 410.41 of this chapter. [53 FR 6646, Mar. 2, 1988; 53 FR 12945, Apr. 20, 1988; 64 FR 3649, Jan. 25, 1999]