[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: 42CFR410.58]



[Page 343]

 

                         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. 410.58  Additional services to HMO and CMP enrollees.



    Services not usually covered under Medicare Part B may be covered as 

medical and other health services if they are furnished to an enrollee 

of an HMO or a CMP and the following conditions are met:

    (a) The services are--

    (1) Furnished by a physician assistant or nurse practitioner as 

defined in Sec. 491.2 of this chapter, or are incident to services 

furnished by such a practitioner; or

    (2) Furnished by a clinical psychologist as defined in Sec. 417.416 

of this chapter to an enrollee of an HMO or CMP that participates in 

Medicare under a risk-sharing contract, or are incident to those 

services.

    (b) The services are services that would be covered under Medicare 

Part B if they were furnished by a physician or as incident to a 

physician's professional services.