---
kind: "section"
citation: "42 C.F.R. § 405.2448"
title: "42"
number: "405.2448"
heading: "Preventive primary services."
url: "https://uscodex.org/cfr/42/405.2448"
---

# §405.2448. Preventive primary services.

- (a) **Preventive primary services are those health services that—**
  - (1) A FQHC is required to provide as preventive primary health services under section 330 of the PHS Act; and
  - (2) Are furnished by a or under the direct supervision of a physician, nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, clinical social worker, marriage and family therapist, or mental health counselor employed by or under contract with the FQHC.
    - (i) By a or under the direct supervision of a physician, nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, clinical social worker, marriage and family therapist, or mental health counselor; or
    - (ii) By a member of the FQHC's health care staff who is an employee of the FQHC or by a physician under arrangements with the FQHC.
  - (3) Except as specifically provided in section 1861(s) of the Act, include only drugs and biologicals that cannot be self-administered.
- (b) Preventive primary services which may be paid for when provided by FQHCs are the following:
  - (1) **Medical social services.**
  - (2) **Nutritional assessment and referral.**
  - (3) **Preventive health education.**
  - (4) **Children's eye and ear examinations.**
  - (5) **Prenatal and post-partum care.**
  - (6) **Perinatal services.**
  - (7) **Well child care, including periodic screening.**
  - (8) **Immunizations, including tetanus-diptheria booster and influenza vaccine.**
  - (9) **Voluntary family planning services.**
  - (10) **Taking patient history.**
  - (11) **Blood pressure measurement.**
  - (12) **Weight.**
  - (13) **Physical examination targeted to risk.**
  - (14) **Visual acuity screening.**
  - (15) **Hearing screening.**
  - (16) **Cholesterol screening.**
  - (17) **Stool testing for occult blood.**
  - (18) **Dipstick urinalysis.**
  - (19) **Risk assessment and initial counseling regarding risks.**
  - (20) **Tuberculosis testing for high risk patients.**
  - (21) **For women only.**
    - (i) **Clinical breast exam.**
    - (ii) Referral for mammography; and
    - (iii) **Thyroid function test.**
- (c) Preventive primary services do not include group or mass information programs, health education classes, or group education activities, including media productions and publications.
- (d) Screening mammography is not considered a FQHC service, but may be provided at a FQHC if the FQHC if the center meets the requirements applicable to that service specified in [§ 410.34](/cfr/42/410.34.md) of this subchapter. Payment is made under applicable Medicare requirements.
- (e) **Preventive primary services do not include eyeglasses, hearing aids, or preventive dental services.**

## Notes

### Amendments

[57 FR 24980, June 12, 1992, as amended at 61 FR 14657, Apr. 3, 1996; 79 FR 25477, May 2, 2014; 80 FR 71371, Nov. 16, 2015; 88 FR 79524, Nov. 16, 2023]

### Source

Source: 57 FR 24978, June 12, 1992, unless otherwise noted.

### Authority

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

### Source

Source: 43 FR 8261, Mar. 1, 1978, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 263a, 405(a), 1302, 1320b-12, 1395x, 1395y(a), 1395ff, 1395hh, 1395kk, 1395rr, and 1395ww(k).

### Amendments

[57 FR 24980, June 12, 1992, as amended at 61 FR 14657, Apr. 3, 1996; 79 FR 25477, May 2, 2014; 80 FR 71371, Nov. 16, 2015; 88 FR 79524, Nov. 16, 2023]