---
kind: "section"
citation: "42 C.F.R. § 409.20"
title: "42"
number: "409.20"
heading: "Coverage of services."
url: "https://uscodex.org/cfr/42/409.20"
---

# §409.20. Coverage of services.

- (a) **Included services.** Subject to the conditions and limitations set forth in this subpart and [subpart D](/cfr/42/subpartD.md) of this part, “posthospital SNF care” means the following services furnished to an inpatient of a participating SNF, or of a participating hospital or critical access hospital (CAH) that has a swing-bed approval:
  - (1) **Nursing care provided by or under the supervision of a registered professional nurse.**
  - (2) **Bed and board in connection with the furnishing of that nursing care.**
  - (3) **Physical therapy, occupational therapy, and speech-language pathology services.**
  - (4) **Medical social services.**
  - (5) **Drugs, biologicals, supplies, appliances, and equipment.**
  - (6) Services furnished by a hospital with which the SNF has a transfer agreement in effect under [§ 483.70(j)](/cfr/42/483.70.md?p=j) of this chapter.
  - (7) **Other services that are generally provided by (or under arrangements made by) SNFs.**
- (b) **Excluded services—**
  - (1) **Services that are not considered inpatient hospital services.** No service is included as posthospital SNF care if it would not be included as an inpatient hospital service under [§§ 409.11 through 409.18](/cfr/42/409.11..409.18.md).
  - (2) **Services not generally provided by (or under arrangements made by) SNFs.** Except as specifically listed in [§§ 409.21 through 409.27](/cfr/42/409.21..409.27.md), only those services generally provided by (or under arrangements made by) SNFs are considered as posthospital SNF care. For example, a type of medical or surgical procedure that is ordinarily performed only on an inpatient basis in a hospital is not included as “posthospital SNF care,” because such procedures are not generally provided by (or under arrangements made by) SNFs.
- (c) **Terminology.** In [§ 409.21](/cfr/42/409.21.md) through [§ 409.36](/cfr/42/409.36.md)—.
  - (1) The terms SNF and swing-bed hospital are used when the context applies to the particular facility.
  - (2) **The term <I>facility</I> is used to mean both SNFs and swing-bed hospitals.**
  - (3) The term swing-bed hospital includes a CAH with swing-bed approval under [subpart F of part 485](/cfr/42/part485-subpartF.md) of this chapter.
  - (4) The term post-hospital SNF care includes SNF care that does not follow a hospital stay when the beneficiary is enrolled in a plan, as defined in [§ 422.4](/cfr/42/422.4.md) of this chapter, offered by a Medicare + Choice (M + C) organization, that includes the benefits described in [§ 422.101(c)](/cfr/42/422.101.md?p=c) of this chapter.

## Notes

### Amendments

[48 FR 12541, Mar. 25, 1983, as amended at 50 FR 33033, Aug. 16, 1985; 58 FR 30667, May 26, 1993; 63 FR 26306, May 12, 1998; 64 FR 3648, Jan. 25, 1999; 64 FR 41681, July 30, 1999; 68 FR 46070, Aug. 4, 2003; 68 FR 50854, Aug. 22, 2003; 69 FR 35529, June 25, 2004; 75 FR 73613, Nov. 29, 2010; 82 FR 32258, July 13, 2017]

### Authority

Authority: 42 U.S.C. 1302 and 1395hh.

### Source

Source: 48 FR 12541, Mar. 25, 1983, unless otherwise noted.

### Amendments

[48 FR 12541, Mar. 25, 1983, as amended at 50 FR 33033, Aug. 16, 1985; 58 FR 30667, May 26, 1993; 63 FR 26306, May 12, 1998; 64 FR 3648, Jan. 25, 1999; 64 FR 41681, July 30, 1999; 68 FR 46070, Aug. 4, 2003; 68 FR 50854, Aug. 22, 2003; 69 FR 35529, June 25, 2004; 75 FR 73613, Nov. 29, 2010; 82 FR 32258, July 13, 2017]