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C.F.R - Table of Contents

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CFR > Title 42 - Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM (parts 405 to 426) > PART 424—CONDITIONS FOR MEDICARE PAYMENT > SUBPART P—Requirements for Establishing and Maintaining Medicare Billing Privileges (§424.500 to §424.565)

SUBPART P—Requirements for Establishing and Maintaining Medicare Billing Privileges (§424.500 to §424.565)

  • 424.500—Scope.
  • 424.502—Definitions.
  • 424.505—Basic enrollment requirement.
  • 424.506—National Provider Identifier (NPI) on all enrollment applications and claims.
  • 424.507—Ordering and referring covered items and services for Medicare beneficiaries.
  • 424.510—Requirements for enrolling in the Medicare program.
  • 424.515—Requirements for reporting changes and updates to, and the periodic revalidation of Medicare enrollment information.
  • 424.516—Additional provider and supplier requirements for enrolling and maintaining active enrollment status in the Medicare program.
  • 424.517—Onsite review.
  • 424.520—Effective date of Medicare billing privileges.
  • 424.521—Request for payment by physicians, nonphysician practitioners, physician or nonphysician organizations.
  • 424.525—Rejection of a provider or supplier's enrollment application for Medicare enrollment.
  • 424.530—Denial of enrollment in the Medicare program.
  • 424.535—Revocation of enrollment and billing privileges in the Medicare program.
  • 424.540—Deactivation of Medicare billing privileges.
  • 424.545—Provider and supplier appeal rights.
  • 424.550—Prohibitions on the sale or transfer of billing privileges.
  • 424.555—Payment liability.
  • 424.565—Overpayment.




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