---
kind: "section"
citation: "42 C.F.R. § 476.83"
title: "42"
number: "476.83"
heading: "Initial denial determinations."
url: "https://uscodex.org/cfr/42/476.83"
---

# §476.83. Initial denial determinations.


A determination by a QIO that the health care services furnished or proposed to be furnished to a patient are not medically necessary, are not reasonable, or are not at the appropriate level of care, is an initial denial determination and is appealable under [part 473](/cfr/42/part473.md) of this chapter.


## Notes

### Source

Source: 50 FR 15330, Apr. 17, 1985, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.

### Authority

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

### Source

Source: 44 FR 32081, June 4, 1979, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.