{"abstract":"This final rule establishes a process for Medicare contractors to provide eligible participating physicians and beneficiaries with a determination of coverage relating to medical necessity for certain physicians' services before the services are furnished. This rule is intended to afford the physician and beneficiary the opportunity to know the financial liability for a service before expenses are incurred. This final rule establishes reasonable limits on physicians' services for which a prior determination of coverage may be requested and discusses generally our plans for establishing the procedures by which those determinations may be obtained. This rule also responds to public comments on the August 30, 2005 proposed rule.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2008/02/22/E8-2811.html","cfr_references":[{"chapter":null,"citation_url":null,"part":410,"title":42}],"citation":"73 FR 9672","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Date: March 24, 2008.","disposition_notes":null,"docket_ids":["CMS-6024-F"],"dockets":[],"document_number":"E8-2811","effective_on":"2008-03-24","end_page":9679,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2008/02/22/E8-2811.xml","html_url":"https://www.federalregister.gov/documents/2008/02/22/E8-2811/medicare-program-prior-determination-for-certain-items-and-services","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/E8-2811?publication_date=2008-02-22","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2008-02-22/E8-2811/mods.xml","not_received_for_publication":null,"page_length":8,"page_views":{"count":284,"last_updated":"2026-09-22 20:15:08 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2008-02-22/pdf/E8-2811.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2008-02-22","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2008/02/22/E8-2811.txt","regulation_id_number_info":{"0938-AN10":{"issue":"200710","html_url":"https://www.federalregister.gov/regulations/0938-AN10/prior-determination-process-for-certain-items-and-services-cms-6024-f-","title":"Prior Determination Process for Certain Items and Services (CMS-6024-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=200710&RIN=0938-AN10&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0938-AN10"],"regulations_dot_gov_info":{"checked_regulationsdotgov_at":"2011-11-13T19:56:11Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":9672,"subtype":null,"title":"Medicare Program; Prior Determination for Certain Items and Services","toc_doc":"Prior Determination for Certain Items and Services","toc_subject":"Medicare Program:","topics":["Health facilities","Health professions","Kidney diseases","Laboratories","Medicare","Reporting and recordkeeping requirements","Rural areas","X-rays"],"type":"Rule","volume":73}