(a) The applicable payments made under the prospective payment systems, as described in subparts H and M of this part, are payment in full for all inpatient hospital services, as defined in § 409.10 of this chapter. Inpatient hospital services do not include the following types of services:
- (1) Physician services that meet the requirements of § 415.102(a) of this chapter for payment on a fee schedule basis.
- (2) Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Act.
- (3) Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act.
- (4) Certified nurse mid-wife services, as defined in section 1861(gg) of the Act.
- (5) Qualified psychologist services, as defined in section 1861(ii) of the Act.
- (6) Services of an anesthetist, as defined in § 410.69 of this chapter.
- (b) CMS does not pay any provider or supplier other than the hospital for services furnished to a beneficiary who is an inpatient, except for the services described in paragraphs (a)(1) through (a)(6) of this section.
- (c) The hospital must furnish all necessary covered services to the beneficiary either directly or under arrangements (as defined in § 409.3 of this chapter).
[50 FR 12741, Mar. 29, 1985, as amended at 53 FR 38527, Sept. 30, 1988; 57 FR 39821, Sept. 1, 1992; 60 FR 63188, Dec. 8, 1995; 65 FR 18537, Apr. 7, 2000]