---
kind: "section"
citation: "42 C.F.R. § 405.920"
title: "42"
number: "405.920"
heading: "Initial determinations."
url: "https://uscodex.org/cfr/42/405.920"
---

# §405.920. Initial determinations.


After a claim is filed with the appropriate contractor in the manner and form described in [subpart C of part 424](/cfr/42/part424-subpartC.md) of this chapter, the contractor must—

- (a) Determine if the items and services furnished are covered or otherwise reimbursable under title XVIII of the Act;
- (b) Determine any amounts payable and make payment accordingly; and
- (c) Notify the parties to the initial determination of the determination in accordance with [§ 405.921](/cfr/42/405.921.md).

## Notes

### Source

Source: 70 FR 11472, Mar. 8, 2005, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 263a, 405(a), 1302, 1320b-12, 1395x, 1395y(a), 1395ff, 1395hh, 1395kk, 1395rr, and 1395ww(k).