[Code of Federal Regulations]
[Title 42, Volume 2]
[Revised as of October 1, 2007]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR410.62]

[Page 355-356]
 
                         TITLE 42--PUBLIC HEALTH
 
                             HUMAN SERVICES
 
PART 410_SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of 
Contents
 
               Subpart B_Medical and Other Health Services
 
Sec.  410.62  Outpatient speech-language pathology services: Conditions 
and exclusions.

    (a) Basic rule. Except as specified in paragraph (a)(3)(ii) of this 
section,

[[Page 356]]

Medicare Part B pays for outpatient speech-language pathology services 
only if they are furnished by an individual who meets the qualifications 
for a speech-language pathologist in Sec.  484.4 of this chapter and 
only under the following conditions:
    (1) They are furnished to a beneficiary while he or she is under the 
care of a physician who is a doctor of medicine or osteopathy.
    (2) They are furnished under a written plan of treatment that--
    (i) Is established by a physician or, effective January 1, 1982, by 
either a physician or the speech-language pathologist who provides the 
services to the particular individual;
    (ii) Is periodically reviewed by a physician; and
    (iii) Meets the requirements of Sec.  410.61.
    (3) They are furnished--
    (i) By a provider as defined in Sec.  489.2 of this chapter, or by 
others under arrangements with, and under the supervision of, a 
provider; or
    (ii) By, or incident to the service of, a physician, physician 
assistant, clinical nurse specialist, or nurse practitioner when those 
professionals may perform speech-language pathology services under State 
law. When a speech-language pathology service is provided incident to 
the services of a physician, physician assistant, clinical nurse 
specialist, or nurse practitioner, by anyone other than a physician, 
physician assistant, clinical nurse specialist, or nurse practitioner, 
the service and the person who furnishes the service must meet the 
standards and conditions that apply to speech-language pathology and 
speech-language pathologists, except that a license to practice speech-
language pathology services in the State is not required.
    (b) Condition for coverage of outpatient speech-language pathology 
services to certain inpatients of a hospital, CAH, or SNF. Medicare Part 
B pays for outpatient speech-language pathology services furnished to an 
inpatient of a hospital, CAH, or SNF who requires the services but has 
exhausted or is otherwise ineligible for benefit days under Medicare 
Part A.
    (c) Excluded services. No service is included as an outpatient 
speech-language pathology service if it is not included as an inpatient 
hospital service if furnished to a hospital or CAH inpatient.
    (d) Limitation. After 1998, outpatient speech-language pathology 
services are subject to the limitation in Sec.  410.60(e).

[51 FR 41339, Nov. 14, 1986, as amended at 53 FR 6648, Mar. 2, 1988; 56 
FR 8852, Mar. 1, 1991; 56 FR 23022, May 20. 1991; 58 FR 30668, May 26, 
1993; 63 FR 58907, Nov. 2, 1998; 69 FR 66422, Nov. 15, 2004]