Initial Determinations

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medicare Program
  6. Federal Health Insurance for the Aged and Disabled
  7. Determinations, Redeterminations, Reconsiderations, and Appeals Under Original Medicare (Part A and Part B)
  8. Initial Determinations

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Section
405.920

Initial determinations.

Section
405.921

Notice of initial determination.

Section
405.922

Time frame for processing initial determinations.

Section
405.924

Actions that are initial determinations.

Section
405.925

Decisions of utilization review committees.

Section
405.926

Actions that are not initial determinations.

Section
405.927

Initial determinations subject to the reopenings process.

Section
405.928

Effect of the initial determination.

Section
405.929

Post-payment review.

Section
405.930

Failure to respond to additional documentation request.