[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR410.10]



[Page 319]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 410_SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of Contents

 

               Subpart B_Medical and Other Health Services

 

Sec. 410.10  Medical and other health services: Included services.





    Subject to the conditions and limitations specified in this subpart, 

``medical and other health services'' includes the following services:

    (a) Physicians' services.

    (b) Services and supplies furnished incident to a physician's 

professional services, of kinds that are commonly furnished in 

physicians' offices and are commonly either furnished without charge or 

included in the physicians' bills.

    (c) Services and supplies, including partial hospitalization 

services, that are incident to physician services and are furnished to 

outpatients by or under arrangements made by a hospital or a CAH.

    (d) Diagnostic services furnished to outpatients by or under 

arrangements made by a hospital or a CAH if the services are services 

that the hospital or CAH ordinarily furnishes to its outpatients for 

diagnostic study.

    (e) Diagnostic laboratory and X-ray tests (including diagnostic 

mammography that meets the conditions for coverage specified in Sec. 

410.34(b) of this subpart) and other diagnostic tests.

    (f) X-ray therapy and other radiation therapy services.

    (g) Medical supplies, appliances, and devices.

    (h) Durable medical equipment.

    (i) Ambulance services.

    (j) Rural health clinic services.

    (k) Home dialysis supplies and equipment; on or after July 1, 1991, 

epoetin (EPO) for home dialysis patients, and, on or after January 1, 

1994, for dialysis patients, competent to use the drug; self-care home 

dialysis support services; and institutional dialysis services and 

supplies.

    (l) Pneumococcal vaccinations.

    (m) Outpatient physical therapy and speech pathology services.

    (n) Cardiac pacemakers and pacemaker leads.

    (o) Additional services furnished to enrollees of HMOs or CMPs, as 

described in Sec. 410.58.

    (p) Hepatitis B vaccine.

    (q) Blood clotting factors for hemophilia patients competent to use 

these factors without medical or other supervision.

    (r) Screening mammography services.

    (s) Federally qualified health center services.

    (t) Services of a certified registered nurse anesthetist or an 

anesthesiologist's assistant.

    (u) Prescription drugs used in immunosuppressive therapy.

    (v) Clinical psychologist services and services and supplies 

furnished as an incident to the services of a clinical psychologist, as 

provided in Sec. 410.71.

    (w) Clinical social worker services, as provided in Sec. 410.73.

    (x) Services of physicians and other practitioners furnished in or 

at the direction of an IHS or Indian tribal hospital or clinic.

    (y) Intravenous immune globulin administered in the home for the 

treatment of primary immune deficiency diseases.



[51 FR 41339, Nov. 14, 1986, as amended at 52 FR 27765, July 23, 1987; 

55 FR 22790, June 4, 1990; 55 FR 53522, Dec. 31, 1990; 56 FR 8841, Mar. 

1, 1991; 56 FR 43709, Sept. 4, 1991; 57 FR 24981, June 12, 1992; 57 FR 

33896, July 31, 1992; 58 FR 30668, May 26, 1993; 59 FR 26959, May 25, 

1994; 59 FR 49833, Sept. 30, 1994; 60 FR 8955, Feb. 16, 1995; 63 FR 

20128, Apr. 23, 1998; 66 FR 55328, Nov. 1, 2001; 69 FR 66420, Nov. 15, 

2004]