42 CFR 447.25 - Direct payments to certain beneficiaries for physicians' or dentists' services.
(a)Basis and purpose. This section implements section 1905(a) of the Act by prescribing requirements applicable to States making direct payments to certain beneficiaries for physicians' or dentists' services.
(b)State plan requirements. Except for groups specified in paragraph (c) of this section, a State may make direct payments to beneficiaries for physicians' or dentists' services. If it does so, the State plan must -
(1) Provide for direct payments; and
(2) Specify the conditions under which payments are made.
(1) Direct payments to beneficiaries under this section are an alternative to payments directly to providers and are subject to the same conditions; for example, the State's reasonable charge schedules are applicable.
(2) Direct payments must be supported by providers' bills for services.