(a) The following RHC and FQHC services are reimbursable under this subpart:
(1) The physicians' services specified in § 405.2412.
(2) Services and supplies furnished as an incident to a physician's professional service.
(3) The nurse practitioner or physician assistant services specified in § 405.2414.
(4) Services and supplies furnished as incident to a nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker service.
(5) Visiting nurse services when provided in accordance with 1861(aa)(1) of the Act and § 405.2416.
(6) Clinical psychologist and clinical social worker services as specified in § 405.2450.
(b) RHC and FQHC services are -
(1) Covered when furnished in a RHC, FQHC, or other outpatient setting, including a patient's place of residence;
(2) Covered when furnished during a Part A stay in a skilled nursing facility only when provided by a physician, nurse practitioner, physician assistant, certified nurse midwife or clinical psychologist employed or under contract with the RHC or FQHC at the time the services are furnished;
(3) Inclusive of hospice attending physician services, and are covered when furnished during a patient's hospice election only when provided by an RHC/FQHC physician, nurse practitioner, or physician assistant designated by the patient as his or her attending physician and employed or under contract with the RHC or FQHC at the time the services are furnished; and
(4) Not covered in a -
(i) Hospital as defined in section 1861(e) of the Act; or
(ii) Critical access hospital as defined in section 1861(mm)(1) of the Act.
[43 FR 8261, Mar. 1, 1978, as amended at 79 FR 25475, May 2, 2014; 86 FR 65660, Nov. 19, 2021]