42 CFR § 441.253 - Sterilization of a mentally competent individual aged 21 or older.

---
identifier: "/us/cfr/t42/s441.253"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 441.253 - Sterilization of a mentally competent individual aged 21 or older."
title_number: 42
title_name: "Public Health"
section_number: "441.253"
section_name: "Sterilization of a mentally competent individual aged 21 or older."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "C"
subchapter_name: "MEDICAL ASSISTANCE PROGRAMS"
part_number: "441"
part_name: "SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 1302."
regulatory_source: "43 FR 45229, Sept. 29, 1978, unless otherwise noted."
cfr_part: "441"
---


# 441.253 Sterilization of a mentally competent individual aged 21 or older.

FFP is available in expenditures for the sterilization of an individual only if—

(a) The individual is at least 21 years old at the time consent is obtained;

(b) The individual is not a mentally incompetent individual;

(c) The individual has voluntarily given informed consent in accordance with all the requirements prescribed in §§ 441.257 and 441.258; and

(d) At least 30 days, but not more than 180 days, have passed between the date of informed consent and the date of the sterilization, except in the case of premature delivery or emergency abdominal surgery. An individual may consent to be sterilized at the time of a premature delivery or emergency abdominal surgery, if at least 72 hours have passed since he or she gave informed consent for the sterilization. In the case of premature delivery, the informed consent must have been given at least 30 days before the expected date of delivery.