[Code of Federal Regulations]
[Title 42, Volume 2]
[Revised as of October 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR410.62]

[Page 269]
 
                         TITLE 42--PUBLIC HEALTH
 
                             HUMAN SERVICES
 
PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of Contents
 
              Subpart B--Medical and Other Health Services
 
Sec. 410.62  Outpatient speech-language pathology services: Conditions and exclusions.

    (a) Basic rule. Medicare Part B pays for outpatient speech pathology 
services if they meet the following conditions:
    (1) They are furnished to a beneficiary while he or she is under the 
care of a physician who is a doctor of medicine or osteopathy.
    (2) They are furnished under a written plan of treatment that--
    (i) Is established by a physician or, effective January 1, 1982, by 
either a physician or the speech pathologist who will provide the 
services to the particular individual;
    (ii) Is periodically reviewed by a physician; and
    (iii) Meets the requirements of Sec. 410.63.
    (3) They are furnished by a provider as defined in Sec. 489.2 of 
this chapter or by others under arrangements with, or under the 
supervision of, a provider.
    (b) Outpatient speech pathology services to certain inpatients of a 
hospital, CAH, or SNF. Medicare Part B pays for outpatient speech 
pathology services furnished to an inpatient of a hospital, CAH, or SNF 
who requires them but has exhausted or is otherwise ineligible for 
benefit days under Medicare Part A.
    (c) Excluded services. No service is included as an outpatient 
speech pathology service if it would not be included as an inpatient 
hospital service if furnished to a hospital or CAH inpatient.
    (d) Limitation. After 1998, outpatient speech-language pathology 
services are subject to the limitation in Sec. 410.60(e).

[51 FR 41339, Nov. 14, 1986, as amended at 53 FR 6648, Mar. 2, 1988; 56 
FR 8852, Mar. 1, 1991; 56 FR 23022, May 20. 1991; 58 FR 30668, May 26, 
1993; 63 FR 58907, Nov. 2, 1998]