§ 410.58 - Additional services to HMO and CMP enrollees.  


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  • § 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.