---
kind: "section"
citation: "45 C.F.R. § 162.1101"
title: "45"
number: "162.1101"
heading: "Health care claims or equivalent encounter information transaction."
url: "https://uscodex.org/cfr/45/162.1101"
---

# §162.1101. Health care claims or equivalent encounter information transaction.


The health care claims or equivalent encounter information transaction is the transmission of either of the following:

- (a) A request to obtain payment, and the necessary accompanying information from a health care provider to a health plan, for health care.
- (b) If there is no direct claim, because the reimbursement contract is based on a mechanism other than charges or reimbursement rates for specific services, the transaction is the transmission of encounter information for the purpose of reporting health care.

## Notes

### Authority

Authority: 42 U.S.C. 1320d—1320d-9 and secs. 1104 and 10109 of Pub. L. 111-148, 124 Stat. 146-154 and 915-917.

### Source

Source: 65 FR 50367, Aug. 17, 2000, unless otherwise noted.