---
kind: "section"
citation: "42 C.F.R. § 419.49"
title: "42"
number: "419.49"
heading: "Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99)."
url: "https://uscodex.org/cfr/42/419.49"
---

# §419.49. Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99).

- (a) **General rule.** CMS provides for an additional payment beyond the standard payment to a hospital for a dose of Tc-99m derived from Mo-99, if at least 50 percent of the Mo-99 in the Tc-99m generator that produced the dose was both irradiated and processed in the United States.
  - (1) Domestically produced Mo-99 refers to Mo-99 that was both irradiated and processed in the United States.
  - (2) Irradiated refers to the process of bombarding a uranium or molybdenum target with radiation in order to produce Mo-99. Irradiation is typically performed with a nuclear reactor or particle accelerator.
  - (3) **Processed refers to the purification of Mo-99 from irradiated material.**
- (b) **Exclusions.** A dose of Tc-99m does not qualify for the add-on payment if more than 50 percent of the Mo-99 in the Tc-99m generator was irradiated or processed outside the United States, even if the Mo-99 has been loaded into a Tc-99m generator in the United States or if the Tc-99m has been eluted at a radiopharmacy in the United States.
  - (1) Eluted refers to the process by which Tc-99m is chemically separated from Mo-99 within the generator and collected in an elution vial.
  - (2) [Reserved]

## Notes

### Amendments

[90 FR 54086, Nov. 25, 2025]

### Authority

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

### Source

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

### Amendments

[90 FR 54086, Nov. 25, 2025]