42 CFR §411.12

1. (a)Basic rule. Medicare does not pay for services usually covered under Medicare if the charges for those services are imposed by—
   1. (1)An immediate relative of the beneficiary; or
   2. (2)A member of the beneficiary's household.
2. (b)Definitions. As used in this section—
   1. (1)Husband or wife.
   2. (2)Natural or adoptive parent, child, or sibling.
   3. (3)Stepparent, stepchild, stepbrother, or stepsister.
   4. (4)Father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law.
   5. (5)Grandparent or grandchild.
   6. (6)Spouse of grandparent or grandchild.
3. (c)Applicability of the exclusion. The exclusion applies to the following charges in the specified circumstances:
   1. (1)Physicians' services.
      1. (i)Charges for physicians' services furnished by an immediate relative of the beneficiary or member of the beneficiary's household, even if the bill or claim is submitted by another individual or by an entity such as a partnership or a professional corporation.
      2. (ii)Charges for services furnished incident to a physician's professional services (for example by the physician's nurse or technician), only if the physician who ordered or supervised the services has an excluded relationship to the beneficiary.
   2. (2)Services other than physicians' services.
      1. (i)Charges imposed by an individually owned provider or supplier if the owner has an excluded relationship to the beneficiary; and
      2. (ii)Charges imposed by a partnership if any of the partners has an excluded relationship to the beneficiary.
4. (d)Exception to the exclusion. The exclusion does not apply to charges imposed by a corporation other than a professional corporation.