---
kind: "section"
citation: "42 C.F.R. § 412.509"
title: "42"
number: "412.509"
heading: "Furnishing of inpatient hospital services directly or under arrangement."
url: "https://uscodex.org/cfr/42/412.509"
---

# §412.509. Furnishing of inpatient hospital services directly or under arrangement.

- (a) Subject to the provisions of [§ 412.521(b)](/cfr/42/412.521.md?p=b), the applicable payments made under this subpart are payment in full for all inpatient hospital services, as defined in [§ 409.10](/cfr/42/409.10.md) of this chapter. Inpatient hospital services do not include the following:
  - (1) Physicians' services that meet the requirements of [§ 415.102(a)](/cfr/42/415.102.md?p=a) of this subchapter 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 practitioners and clinical nurse specialist services, as defined in [section 1861(s)(2)(K)(ii)](/cfr/42/1861.md?p=s-2-K-ii) of the Act.
  - (4) **Certified nurse midwife 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](/cfr/42/410.69.md) of this subchapter.
- (b) Medicare does not pay any provider or supplier other than the long-term care hospital for services furnished to a Medicare beneficiary who is an inpatient of the hospital except for services described in [paragraphs (a)(1) through (a)(6)](#a-1..a-6) of this section.
- (c) The long-term care hospital must furnish all necessary covered services to the Medicare beneficiary who is an inpatient of the hospital either directly or under arrangements (as defined in [§ 409.3](/cfr/42/409.3.md) of this subchapter).

## Notes

### Source

Source: 67 FR 56049, Aug. 30, 2002, unless otherwise noted.

### Authority

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

### Source

Source: 50 FR 12741, Mar. 29, 1985, unless otherwise noted.