[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR433.56]



[Page 82]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 433_STATE FISCAL ADMINISTRATION--Table of Contents

 

     Subpart B_General Administrative Requirements State Financial 

                              Participation

 

Sec.  433.56  Classes of health care services and providers defined.



    (a) For purposes of this subpart, each of the following will be 

considered as a separate class of health care items or services:

    (1) Inpatient hospital services;

    (2) Outpatient hospital services;

    (3) Nursing facility services (other than services of intermediate 

care facilities for the mentally retarded);

    (4) Intermediate care facility services for the mentally retarded, 

and similar services furnished by community-based residences for the 

mentally retarded, under a waiver under section 1915(c) of the Act, in a 

State in which, as of December 24, 1992, at least 85 percent of such 

facilities were classified as ICF/MRs prior to the grant of the waiver;

    (5) Physician services;

    (6) Home health care services;

    (7) Outpatient prescription drugs;

    (8) Services of health maintenance organizations and health insuring 

organizations;

    (9) Ambulatory surgical center services, as described for purposes 

of the Medicare program in section 1832(a)(2)(F)(i) of the Social 

Security Act. These services are defined to include facility services 

only and do not include surgical procedures;

    (10) Dental services;

    (11) Podiatric services;

    (12) Chiropractic services;

    (13) Optometric/optician services;

    (14) Psychological services;

    (15) Therapist services, defined to include physical therapy, speech 

therapy, occupational therapy, respiratory therapy, audiological 

services, and rehabilitative specialist services;

    (16) Nursing services, defined to include all nursing services, 

including services of nurse midwives, nurse practitioners, and private 

duty nurses;

    (17) Laboratory and x-ray services, defined as services provided in 

a licensed, free-standing laboratory or x-ray facility. This definition 

does not include laboratory or x-ray services provided in a physician's 

office, hospital inpatient department, or hospital outpatient 

department;

    (18) Emergency ambulance services; and

    (19) Other health care items or services not listed above on which 

the State has enacted a licensing or certification fee, subject to the 

following:

    (i) The fee must be broad based and uniform or the State must 

receive a waiver of these requirements;

    (ii) The payer of the fee cannot be held harmless; and

    (iii) The aggregate amount of the fee cannot exceed the State's 

estimated cost of operating the licensing or certification program.

    (b) Taxes that pertain to each class must apply to all items and 

services within the class, regardless of whether the items and services 

are furnished by or through a Medicaid-certified or licensed provider.



[57 FR 55138, Nov. 24, 1992, as amended at 58 FR 43180, Aug. 13, 1993]