---
kind: "section"
citation: "42 C.F.R. § 424.127"
title: "42"
number: "424.127"
heading: "Payment to the beneficiary."
url: "https://uscodex.org/cfr/42/424.127"
---

# §424.127. Payment to the beneficiary.

- (a) **Conditions for payment of inpatient hospital services.** Medicare pays the beneficiary if—
  - (1) The hospital does not have in effect an election to claim payment; and
  - (2) **The beneficiary, or someone on his or her behalf, submits—**
    - (i) A claim in accordance with [§ 424.32](/cfr/42/424.32.md);
    - (ii) An itemized hospital bill; and
    - (iii) **Evidence requested by CMS to establish that the services meet the requirements of this subpart.**
- (b) **Amount payable for inpatient hospital services.** The amount payable to the beneficiary is determined in accordance with [§ 424.109(b)](/cfr/42/424.109.md?p=b).
- (c) **Conditions for payment for Part B services.** Medicare pays the beneficiary for physicians' services and ambulance services as specified in [§ 424.121](/cfr/42/424.121.md), if an itemized bill for the services is submitted by the beneficiary or someone on his or her behalf and the conditions of [§ 424.126(a)](/cfr/42/424.126.md?p=a) (2) and (3) are met.
- (d) The amount payable to the beneficiary is determined in accordance with [§ 410.152](/cfr/42/410.152.md) of this chapter.

## Notes

### Authority

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

### Source

Source: 53 FR 6634, Mar. 2, 1988, unless otherwise noted.