42 CFR § 419.49 - Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99).
---
identifier: "/us/cfr/t42/s419.49"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 419.49 - Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99)."
title_number: 42
title_name: "Public Health"
section_number: "419.49"
section_name: "Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99)."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "B"
subchapter_name: "MEDICARE PROGRAM"
part_number: "419"
part_name: "PROSPECTIVE PAYMENT SYSTEMS FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES"
positive_law: false
currency: "2026-04-05"
last_updated: "2026-04-05"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302, 1395l(t), and 1395hh."
regulatory_source: "65 FR 18542, Apr. 7, 2000, unless otherwise noted."
cfr_part: "419"
---
# 419.49 Additional payment for technetium-99m (Tc-99m) derived from domestically produced molybdenum-99 (Mo-99).
(a) *General rule.* CMS provides for an additional payment beyond the standard payment to a hospital for a dose of Tc-99m derived from Mo-99, if at least 50 percent of the Mo-99 in the Tc-99m generator that produced the dose was both irradiated and processed in the United States.
(1) Domestically produced Mo-99 refers to Mo-99 that was both irradiated and processed in the United States.
(2) Irradiated refers to the process of bombarding a uranium or molybdenum target with radiation in order to produce Mo-99. Irradiation is typically performed with a nuclear reactor or particle accelerator.
(3) Processed refers to the purification of Mo-99 from irradiated material.
(b) *Exclusions.* A dose of Tc-99m does not qualify for the add-on payment if more than 50 percent of the Mo-99 in the Tc-99m generator was irradiated or processed outside the United States, even if the Mo-99 has been loaded into a Tc-99m generator in the United States or if the Tc-99m has been eluted at a radiopharmacy in the United States.
(1) Eluted refers to the process by which Tc-99m is chemically separated from Mo-99 within the generator and collected in an elution vial.
(2) [Reserved]
[90 FR 54086, Nov. 25, 2025]