StacksVerified U.S. regulatory reference

42 CFR §410.58

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
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:
  1. (a)The services are—
    1. (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. (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.
  2. (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.