---
kind: "section"
citation: "42 C.F.R. § 416.30"
title: "42"
number: "416.30"
heading: "Terms of agreement with CMS."
url: "https://uscodex.org/cfr/42/416.30"
---

# §416.30. Terms of agreement with CMS.


As part of the agreement under [§ 416.26](/cfr/42/416.26.md) the ASC must agree to the following:

- (a) **Compliance with coverage conditions.** The ASC agrees to meet the conditions for coverage specified in subpart C of this part and to report promptly to CMS any failure to do so.
- (b) **Limitation on charges to beneficiaries.** 1 The ASC agrees to charge the beneficiary or any other person only the applicable deductible and coinsurance amounts for facility services for which the beneficiary—
  - (1) Is entitled to have payment made on his or her behalf under this part; or
  - (2) Would have been so entitled if the ASC had filed a request for payment in accordance with [§ 410.165](/cfr/42/410.165.md) of this chapter.
- (c) **Refunds to beneficiaries.**
  - (1) The ASC agrees to refund as promptly as possible any money incorrectly collected from beneficiaries or from someone on their behalf.
  - (2) As used in this section, money incorrectly collected means sums collected in excess of those specified in [paragraph (b)](#b) of this section. It includes amounts collected for a period of time when the beneficiary was believed not to be entitled to Medicare benefits if—
    - (i) The beneficiary is later determined to have been entitled to Medicare benefits; and
    - (ii) **The beneficiary's entitlement period falls within the time the ASC's agreement with CMS is in effect.**
- (d) **Furnishing information.** The ASC agrees to furnish to CMS, if requested, information necessary to establish payment rates specified in [§§ 416.120-416.130](/cfr/42/416.120-416.130.md) in the form and manner that CMS requires.
- (e) **Acceptance of assignment.** The ASC agrees to accept assignment for all facility services furnished in connection with covered surgical procedures. For purposes of this section, assignment means an assignment under [§ 424.55](/cfr/42/424.55.md) of this chapter of the right to receive payment under Medicare Part B and payment under [§ 424.64](/cfr/42/424.64.md) of this chapter (when an individual dies before assigning the claim).
- (f) **ASCs operated by a hopsital.** In an ASC operated by a hospital—
  - (1) The agreement is made effective on the first day of the next Medicare cost reporting period of the hospital that operates the ASC; and
  - (2) **The ASC participates and is paid only as an ASC.**
  - (3) **Costs for the ASC are treated as a non-reimbursable cost center on the hopsital's cost report.**
- (g) **Additional provisions.** The agreement may contain any additional provisions that CMS finds necessary or desirable for the efficient and effective administration of the Medicare program.

## Notes

### Amendments

[47 FR 34094, Aug. 5, 1982, as amended at 51 FR 41351, Nov. 14, 1986; 56 FR 8844, Mar. 1, 1991; 74 FR 60680, Nov. 20, 2009]

### Authority

Authority: 42 U.S.C. 273, 1302, 1320b-8, and 1395hh.

### Source

Source: 47 FR 34094, Aug. 5, 1982, unless otherwise noted.

### Amendments

[47 FR 34094, Aug. 5, 1982, as amended at 51 FR 41351, Nov. 14, 1986; 56 FR 8844, Mar. 1, 1991; 74 FR 60680, Nov. 20, 2009]