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Notes

42 C.F.R. §§ 410.22–410.25

4 sections in range

§410.22. Limitations on services of an optometrist.

42 C.F.R. § 410.22

Medicare Part B pays for the services of a doctor of optometry, which he or she is legally authorized to perform in the State in which he or she performs them, if the services are among those described in section 1861(s) of the Act and § 410.10 of this part.
Notes, amendments, and revision history

Amendments

[64 FR 59439, Nov. 2, 1999. Redesignated at 66 FR 55328, Nov. 1, 2001]

Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.

Amendments

[64 FR 59439, Nov. 2, 1999. Redesignated at 66 FR 55328, Nov. 1, 2001]

§410.23. Screening for glaucoma: Conditions for and limitations on coverage.

42 C.F.R. § 410.23

(a)
Definitions— As used in this section, the following definitions apply:
(1)
Direct supervision in the office setting means the optometrist or the ophthalmologist must be present in the office suite and be immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean the physician must be present in the room when the procedure is performed.
(2)
Eligible beneficiary means individuals in the following high risk categories:
(i)
Individual with diabetes mellitus.
(ii)
Individual with a family history of glaucoma.
(iii)
African-Americans age 50 and over.
(iv)
Hispanic-Americans age 65 and over.
(3)
Screening for glaucoma means the following procedures furnished to an individual for the early detection of glaucoma:
(i)
A dilated eye examination with an intraocular pressure measurement.
(ii)
A direct ophthalmoscopy examination, or a slit-lamp biomicroscopic examination.
(b)
Condition for coverage of screening for glaucoma. Medicare Part B pays for glaucoma screening examinations provided to eligible beneficiaries as described in paragraph (a)(2) of this section if they are furnished by or under the direct supervision in the office setting of an optometrist or ophthalmologist who is legally authorized to perform these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished, as would otherwise be covered if furnished by a physician or incident to a physician's professional service.
(c)
Limitations on coverage of glaucoma screening examinations.
(1)
Payment may not be made for a glaucoma screening examination that is performed for an individual who is not an eligible beneficiary as described in paragraph (a)(2) of this section.
(2)
Payment may be made for a glaucoma screening examination that is performed on an individual who is an eligible beneficiary as described in paragraph (a)(2) of this section, after at least 11 months have passed following the month in which the last glaucoma screening examination was performed.
Notes, amendments, and revision history

Amendments

[66 FR 55328, Nov. 1, 2001, as amended at 70 FR 70330, Nov. 21, 2005]

Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.

Amendments

[66 FR 55328, Nov. 1, 2001, as amended at 70 FR 70330, Nov. 21, 2005]

§410.24. Limitations on services of a doctor of dental surgery or dental medicine.

42 C.F.R. § 410.24

Medicare Part B pays for services furnished by a doctor of dental surgery or dental medicine within the scope of his or her license, if the services would be covered as physicians' services when performed by a doctor of medicine or osteopathy. 1
Notes, amendments, and revision history

Amendments

[51 FR 41339, Nov. 14, 1986, as amended at 56 FR 8852, Mar. 1, 1991]

Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.

Amendments

[51 FR 41339, Nov. 14, 1986, as amended at 56 FR 8852, Mar. 1, 1991]

§410.25. Limitations on services of a podiatrist.

42 C.F.R. § 410.25

Medicare Part B pays for the services of a doctor of podiatric medicine, acting within the scope of his or her license, if the services would be covered as physicians' services when performed by a doctor of medicine or osteopathy.
Notes, amendments, and revision history

Authority

Authority: 42 U.S.C. 1302, 1395m, 1395hh, 1395rr, and 1395ddd.

Source

Source: 51 FR 41339, Nov. 14, 1986, unless otherwise noted.