[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

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

[CITE: 42CFR485.705]



[Page 614-616]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 485_CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS--Table 

of Contents

 

   Subpart H_Conditions of Participation for Clinics, Rehabilitation 

Agencies, and Public Health Agencies as Providers of Outpatient Physical 

             Therapy and Speech-Language Pathology Services

 

Sec. 485.705  Personnel qualifications.



    (a) General qualification requirements. Except as specified in 

paragraphs (b) and (c) of this section, all personnel who are involved 

in the furnishing of outpatient physical therapy, occupational therapy, 

and speech-language pathology services directly by or under arrangements 

with an organization must be legally authorized (licensed or, if 

applicable, certified or registered) to practice by the State in which 

they perform the functions or actions, and must act only within the 

scope of their State license or State certification or registration.



[[Page 615]]



    (b) Exception for Federally defined qualifications. The following 

Federally defined qualifications must be met:

    (1) For a physician, the qualifications and conditions as defined in 

section 1861(r) of the Act and the requirements in part 484 of this 

chapter.

    (2) For a speech-language pathologist, the qualifications specified 

in section 1861(11)(1) of the Act and the requirements in part 484 of 

this chapter.

    (c) Exceptions when no State Licensing laws or State certification 

or registration requirements exist. If no State licensing laws or State 

certification or registration requirements exist for the profession, the 

following requirements must be met--

    (1) An administrator is a person who has a bachelor's degree and:

    (i) Has experience or specialized training in the administration of 

health institutions or agencies; or

    (ii) Is qualified and has experience in one of the professional 

health disciplines.

    (2) An occupational therapist must meet the requirements in part 484 

of this chapter.

    (3) An occupational therapy assistant must meet the requirements in 

part 484 of this chapter.

    (4) A physical therapist must meet the requirements in part 484 of 

this chapter.

    (5) A physical therapist assistant must meet the requirements in 

part 484 of this chapter.

    (6) A social worker must meet the requirements in part 484 of this 

chapter.

    (7) A vocational specialist is a person who has a baccalaureate 

degree and--

    (i) Two years experience in vocational counseling in a 

rehabilitation setting such as a sheltered workshop, State employment 

service agency, etc.; or

    (ii) At least 18 semester hours in vocational rehabilitation, 

educational or vocational guidance, psychology, social work, special 

education or personnel administration, and 1 year of experience in 

vocational counseling in a rehabilitation setting; or

    (iii) A master's degree in vocational counseling.

    (8) A nurse practitioner is a person who must:

    (i) Be a registered professional nurse who is authorized by the 

State in which the services are furnished to practice as a nurse 

practitioner in accordance with State law; and

    (ii) Be certified as a nurse practitioner by a recognized national 

certifying body that has established standards for nurse practitioners; 

or

    (iii) Be a registered professional nurse who is authorized by the 

State in which the services are furnished to practice as a nurse 

practitioner in accordance with State law and have been granted a 

Medicare billing number as a nurse practitioner by December 31, 2000; or

    (iv) Be a nurse practitioner who on or after January 1, 2001, 

applies for a Medicare billing number for the first time and meets the 

standards for nurse practitioners in paragraphs (c)(8)(i) and (c)(8)(ii) 

of this section; or

    (v) Be a nurse practitioner who on or after January 1, 2003, applies 

for a Medicare billing number for the first time and possesses a 

master's degree in nursing and meets the standards for nurse 

practitioners in paragraphs (b)(1)(i) and (b)(1)(ii) of this section.

    (9) A clinical nurse specialist is a person who must:

    (i) Be a registered nurse who is currently licensed to practice in 

the State where he or she practices and be authorized to perform the 

services of a clinical nurse specialist in accordance with State law;

    (ii) Have a master's degree in a defined clinical area of nursing 

from an accredited educational institution; and,

    (iii) Be certified as a clinical nurse specialist by the American 

Nurses Credentialing Center.

    (10) A physician assistant is a person who:

    (i) Has graduated from a physician assistant educational program 

that is accredited by the Commission on Accreditation of Allied Health 

Education Programs; or

    (ii) Has passed the national certification examination that is 

administered by the National Commission on Certification of Physician 

Assistants; and



[[Page 616]]



    (iii) Is licensed by the State to practice as a physician assistant.



[63 FR 58912, Nov. 2, 1998; 64 FR 25457, May 12, 1999; 64 FR 59442, Nov. 

2, 1999]