---
kind: "section"
citation: "42 C.F.R. § 419.45"
title: "42"
number: "419.45"
heading: "Payment and copayment reduction for devices replaced without cost or when full or partial credit is received."
url: "https://uscodex.org/cfr/42/419.45"
---

# §419.45. Payment and copayment reduction for devices replaced without cost or when full or partial credit is received.

- (a) **General rule.** CMS reduces the amount of payment for an implanted device made under the hospital outpatient prospective payment system in accordance with [§ 419.66](/cfr/42/419.66.md) for which CMS determines that a significant portion of the payment is attributable to the cost of an implanted device, when one of the following situations occur:
  - (1) The device is replaced without cost to the provider or the beneficiary;
  - (2) The provider receives full credit for the cost of a replaced device; or
  - (3) The provider receives partial credit for the cost of a replaced device but only where the amount of the device credit is greater than or equal to 50 percent of the cost of the new replacement device being implanted.
- (b) **Amount of reduction to the APC payment.**
  - (1) The amount of the reduction to the APC payment made under paragraphs [(a)(1)](#a-1) and [(2)](#a-2) of this section is calculated as the lesser of the device offset amount that would be applied if the device implanted during a procedure assigned to the APC had transitional pass-through status under [§ 419.66](/cfr/42/419.66.md) or the amount of the credit described in [paragraph (a)(2)](#a-2) of this section.
  - (2) The amount of the reduction to the APC payment made under [paragraph (a)(3)](#a-3) of this section is calculated as the lesser of the device offset amount that would be applied if the device implanted during a procedure assigned to the APC had transitional pass-through status under [§ 419.66](/cfr/42/419.66.md) or the amount of the credit described in [paragraph (a)(3)](#a-3) of this section.
- (c) **Amount of beneficiary copayment.** The beneficiary copayment is calculated based on the APC payment after application of the reduction under [paragraph (b)](#b) of this section.

## Notes

### Amendments

[71 FR 68228, Nov. 24, 2006, as amended at 72 FR 66933, Nov. 27, 2007; 85 FR 86302, Dec. 29, 2020]

### Authority

Authority: 42 U.S.C. 1302, 1395l(t), and 1395hh.

### Source

Source: 65 FR 18542, Apr. 7, 2000, unless otherwise noted.

### Amendments

[71 FR 68228, Nov. 24, 2006, as amended at 72 FR 66933, Nov. 27, 2007; 85 FR 86302, Dec. 29, 2020]