[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: 42CFR416.61]



[Page 816]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 416_AMBULATORY SURGICAL SERVICES--Table of Contents

 

                       Subpart D_Scope of Benefits

 

Sec. 416.61  Scope of facility services.



    (a) Included services. Facility services include, but are not 

limited to--

    (1) Nursing, technician, and related services;

    (2) Use of the facilities where the surgical procedures are 

performed;

    (3) Drugs, biologicals, surgical dressings, supplies, splints, 

casts, and appliances and equipment directly related to the provision of 

surgical procedures;

    (4) Diagnostic or therapeutic services or items directly related to 

the provision of a surgical procedure;

    (5) Administrative, recordkeeping and housekeeping items and 

services; and

    (6) Materials for anesthesia.

    (7) Intra-ocular lenses (IOLs).

    (8) Supervision of the services of an anesthetist by the operating 

surgeon.

    (b) Excluded services. Facility services do not include items and 

services for which payment may be made under other provisions of part 

405 of this chapter, such as physicians' services, laboratory, X-ray or 

diagnostic procedures (other than those directly related to performance 

of the surgical procedure), prosthetic devices (except IOLs), ambulance 

services, leg, arm, back and neck braces, artificial limbs, and durable 

medical equipment for use in the patient's home. In addition, they do 

not include anesthetist services furnished on or after January 1, 1989.



[56 FR 8844, Mar. 1, 1991, as amended at 57 FR 33899, July 31, 1992]