---
kind: "section"
citation: "42 C.F.R. § 424.34"
title: "42"
number: "424.34"
heading: "Additional requirements: Beneficiary's claim for direct payment."
url: "https://uscodex.org/cfr/42/424.34"
---

# §424.34. Additional requirements: Beneficiary's claim for direct payment.

- (a) **Basic rule.** A beneficiary's claim for direct payment for services furnished by a supplier, or by a nonparticipating hospital that has not elected to claim payment for emergency services, must include an itemized bill or a “report of services”, as specified in paragraphs [(b)](#b) and [(c)](#c) of this section.
- (b) **Itemized bill from the hospital or supplier.** The itemized bill for the services, which may be receipted or unpaid, must include all of the following information:
  - (1) **The name and address of—**
    - (i) The beneficiary;
    - (ii) The supplier or nonparticipating hospital that furnished the services; and
    - (iii) The physician who prescribed the services if they were furnished by a supplier other than the physician.
  - (2) The place where each service was furnished, e.g., home, office, independent laboratory, hospital.
  - (3) **The date each service was furnished.**
  - (4) A listing of the services in sufficient detail to permit determination of payment under the fee schedule for physicians' services; for itemized bills from physicians, appropriate diagnostic coding using ICD-9-CM must be used.
  - (5) **The charges for each service.**
- (c) **Report of services furnished by a supplier.** For Medicare Part B services furnished by a supplier, the beneficiary claims may include the “Report of Services” portion of the appropriate claims form, completed by the supplier in accordance with CMS instructions, in lieu of an itemized bill.

## Notes

### Amendments

[53 FR 6634, Mar. 2, 1988, as amended at 59 FR 10299, Mar. 4, 1994; 59 FR 26740, May 24, 1994]

### Authority

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

### Source

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

### Amendments

[53 FR 6634, Mar. 2, 1988, as amended at 59 FR 10299, Mar. 4, 1994; 59 FR 26740, May 24, 1994]