(a) Conditions for payment of inpatient hospital services. Medicare pays the beneficiary if—
- (1) The hospital does not have in effect an election to claim payment; and
(2) The beneficiary, or someone on his or her behalf, submits—
- (i) A claim in accordance with § 424.32;
- (ii) An itemized hospital bill; and
- (iii) Evidence requested by CMS to establish that the services meet the requirements of this subpart.
- (b) Amount payable for inpatient hospital services. The amount payable to the beneficiary is determined in accordance with § 424.109(b).
- (c) Conditions for payment for Part B services. Medicare pays the beneficiary for physicians' services and ambulance services as specified in § 424.121, if an itemized bill for the services is submitted by the beneficiary or someone on his or her behalf and the conditions of § 424.126(a) (2) and (3) are met.
- (d) The amount payable to the beneficiary is determined in accordance with § 410.152 of this chapter.