42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies.
(a)Nursing facility services.
(1) “Nursing facility services for individuals age 21 or older, other than services in an institution for mental diseases”, means services that are -
(ii) Provided by -
(A) A facility or distinct part (as defined in § 483.5(b) of this chapter) that meets the requirements for participation under subpart B of part 483 of this chapter, as evidenced by a valid agreement between the Medicaid agency and the facility for providing nursing facility services and making payments for services under the plan; or
(iii) Ordered by and provided under the direction of a physician.
(2) Nursing facility services include services provided by any facility located on an Indian reservation and certified by the Secretary as meeting the requirements of subpart B of part 483 of this chapter.
(b)EPSDT. “Early and periodic screening and diagnosis and treatment” means -
(1) Screening and diagnostic services to determine physical or mental defects in beneficiaries under age 21; and
(2) Health care, treatment, and other measures to correct or ameliorate any defects and chronic conditions discovered. (See subpart B of part 441 of this chapter.)
(c)Family planning services and supplies for individuals of child-bearing age. [Reserved]
- 42 CFR 442.2 — Terms.
- 42 CFR 441.55 — State Plan Requirements.
- 42 CFR 440.170 — Any Other Medical Care or Remedial Care Recognized Under State Law and Specified by the Secretary.
- 42 CFR 442.30 — Agreement as Evidence of Certification.
- 42 CFR 440.250 — Limits on Comparability of Services.
- 42 CFR 440.140 — Inpatient Hospital Services, Nursing Facility Services, and Intermediate Care Facility Services for Individuals Age 65 or Older in Institutions for Mental Diseases.
- 42 CFR 447.280 — Hospital Providers of NF Services (Swing-Bed Hospitals).