---
kind: "section"
citation: "42 C.F.R. § 410.12"
title: "42"
number: "410.12"
heading: "Medical and other health services: Basic conditions and limitations."
url: "https://uscodex.org/cfr/42/410.12"
---

# §410.12. Medical and other health services: Basic conditions and limitations.

- (a) **Basic conditions.** The medical and other health services specified in [§ 410.10](/cfr/42/410.10.md) are covered by Medicare Part B only if they are not excluded under [subpart A of part 411](/cfr/42/part411-subpartA.md) of this chapter, and if they meet the following conditions:
  - (1) **When the services must be furnished.** The services must be furnished while the individual is in a period of entitlement. (The rules on entitlement are set forth in [part 406](/cfr/42/part406.md) of this chapter.)
  - (2) **By whom the services must be furnished.** The services must be furnished by a facility or other entity as specified in [§§ 410.14 through 410.69](/cfr/42/410.14..410.69.md).
  - (3) **Physician certification and recertification requirements.** If the services are subject to physician certification requirements, they must be certified as being medically necessary, and as meeting other applicable requirements, in accordance with [subpart B of part 424](/cfr/42/part424-subpartB.md) of this chapter.
- (b) **Limitations on payment.** Payment for medical and other health services is subject to limitations on the amounts of payment as specified in §§ [410.152](/cfr/42/410.152.md) and [410.155](/cfr/42/410.155.md) and to the annual and blood deductibles as set forth in §§ [410.160](/cfr/42/410.160.md) and [410.161](/cfr/42/410.161.md).

## Notes

### Amendments

[51 FR 41339, Nov. 14, 1986, as amended at 53 FR 6648, Mar. 2, 1988; 57 FR 33896, July 31, 1992]

### Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

### Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.

### Amendments

[51 FR 41339, Nov. 14, 1986, as amended at 53 FR 6648, Mar. 2, 1988; 57 FR 33896, July 31, 1992]