Provider-based entity

Provider-based entity means a provider of health care services, or an RHC as defined in 405.2401 of this chapter, that is either created by, or acquired by, a main provider for the purpose of furnishing health care services of a different type from those of the main provider under the ownership and administrative and financial control of the main provider, in accordance with the provisions of this section. A provider-based entity comprises both the specific physical facility that serves as the site of services of a type for which payment could be claimed under the Medicare or Medicaid program, and the personnel and equipment needed to deliver the services at that facility. A provider-based entity may, by itself, be qualified to participate in Medicare as a provider under 489.2 of this chapter, and the Medicare conditions of participation do apply to a provider-based entity as an independent entity.


42 CFR § 413.65

Scoping language

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