Federal
Additional services to HMO and CMP enrollees.
42 CFR § 410.58
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42 CFR § 410.58
42 CFR § 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 § 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 § 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.
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