HI 00601.000 Hospital Insurance

Subchapter Table of Contents
Section Latest
Transmittal
Hospital Insurance
HI 00601.001Scope of Benefits 
HI 00601.005Covered Part A Inpatient Hospital Services 
HI 00601.010Hospital Inpatient Services - Coverage Guidelines 
HI 00601.015Bed and Board 
HI 00601.020Nursing and Other Services 
HI 00601.025Drugs and Biologicals 
HI 00601.030Supplies, Appliances and Equipment 
HI 00601.035Other Diagnostic or Therapeutic Items or Services 
HI 00601.040Services of Interns or Residents-in-Training 
HI 00601.045Inpatient Services in Connection with Dental Services 
HI 00601.050Therapy Services 
HI 00601.055Inpatient Hospital Services Counting Toward Maximums 
HI 00601.060Guarantee of Payment for Inpatient Hospital Service 
HI 00601.065Lifetime Reserve Days 
HI 00601.070Inpatient Day Defined 
HI 00601.075Late Discharge 
HI 00601.080Leaves of Absence 
HI 00601.085Discharge or Death on First Day of Entitlement or Participation 
Psychiatric Reduction
HI 00601.090Limitation on Inpatient Psychiatric Benefits in Initial Benefit Period 
HI 00601.095Patient's Status in Applying Reduction 
HI 00601.100Institution's Status in Determining Reduction in Days 
HI 00601.105Counting Days of Admission, Discharge, and Leave in Reducing Days 
HI 00601.110Inpatient Psychiatric Hospital Services—Lifetime Limitation 
HI 00601.115Inpatient Service Days Counting Toward Maximums 
Extended Care Services—Coverage
HI 00601.120Coverage of Extended Care Services 
HI 00601.125SNF Coverage Guidelines 
Requirements for Coverage
HI 00601.130Prior Hospitalization and Transfer Requirements 
HI 00601.135Covered Level of Care 
HI 00601.140Daily Skilled Service 
HI 00601.145Skilled Nursing Services 
HI 00601.150Nonskilled Nursing Services 
HI 00601.155Questionable Situations 
HI 00601.160Physical Therapy as Basis for Extended Care 
HI 00601.165Other Rehabilitation Service as a Basis for Extended Care 
HI 00601.170Need Satisfied Only by SNF Inpatient Care 
Part A Covered Extended Care Services
HI 00601.175Covered Extended Care Services 
HI 00601.180Nursing Care Provided by or Under the Supervision of a Registered Professional Nurse 
HI 00601.185Bed and Board in Semi-Private Accommodations Furnished in Connection With Nursing Care 
HI 00601.190Physical, Speech and Occupational Therapy Furnished by the SNF or by Others Under Arrangements with the SNF and Under Its Supervision 
HI 00601.195Medical Social Services 
HI 00601.200Drugs and Biologicals 
HI 00601.205Supplies, Appliances and Equipment 
HI 00601.210Medical Services of an Intern or Resident-in-Training 
HI 00601.220Other Diagnostic or Therapeutic Services Provided by a Hospital 
HI 00601.230Other Services 
Duration of Covered Extended Care Services
HI 00601.270Extended Care Benefit Days 
HI 00601.280Inpatient Extended Care Services Counting Toward Maximums 
Hospice Care - Coverage
HI 00601.290Covered Hospice Services 
HI 00601.295Hospice Care - Requirements for Coverage 
Home Health Services—Coverage
HI 00601.300Home Health Services 
HI 00601.310HHA Coverage—Discussion Guidelines 
Covered Services
HI 00601.320Nursing Care 
HI 00601.330Definition of “Intermittent” 
HI 00601.340When Skilled Nursing Care is Reimbursable 
HI 00601.350Skilled Nursing Services—Examples 
HI 00601.360Student Nurses 
HI 00601.370Psychiatric Nursing 
HI 00601.380Physical, Speech and Occupational Therapy Furnished by an HHA or by Others Under Arrangements With the HHA and Under its Supervision 
Other Home Health Services
HI 00601.390Medical Social Services 
HI 00601.400Services of a Home Health Aide 
HI 00601.410Medical Supplies (Except for Drugs and Biologicals) and the Use of Medical Appliances 
HI 00601.420Services of Interns and Residents 
HI 00601.430Outpatient Services 
HI 00601.440Part Time or Intermittent Services 
HI 00601.450Counting Visits Under the Hospital and Medical Plans 
HHA Exclusions
HI 00601.460Specific Exclusions from Coverage as Home Health Services 
Home Health Services—Part A
HI 00601.470Special Conditions for Coverage of Home Health Services Under Hospital Insurance (Part A) 
HI 00601.480Fourteen Day Limit on Plan Establishment 
HI 00601.490Related Illness or Impairment 
HI 00601.500Transfer of Patient 
HI 00601.510Duration of Home Health Services Under Hospital Insurance 
HI 00601.520Presumption of Coverage 
HI 00601.550Inpatient Hospital DeductibleTN 2 10-04
HI 00601.560Inpatient Hospital CoinsuranceTN 2 10-04
HI 00601.570Extended Care CoinsuranceTN 2 10-04
HI 00601.575Basis for Determining the Coinsurance Amounts 
HI 00601.580Part A Blood Deductible 
Provider Cost Limits
HI 00601.590Background 
HI 00601.600Provider Charges to Beneficiaries for Excess Costs 
HI 00601.610Determining Emergency Services 
HI 00601.620District Office Role 

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HI 00601.000 - Hospital Insurance - Table of Contents - 09/29/1995
Batch run: 11/30/2016
Rev:09/29/1995