---
kind: "section"
citation: "42 C.F.R. § 440.40"
title: "42"
number: "440.40"
heading: "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."
url: "https://uscodex.org/cfr/42/440.40"
---

# §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—
    - (i) Needed on a daily basis and required to be provided on an inpatient basis under [§§ 409.31 through 409.35](/cfr/42/409.31..409.35.md) of this chapter.
    - (ii) **Provided by—**
      - (A) A facility or distinct part (as defined in [§ 483.5(b)](/cfr/42/483.5.md?p=b) of this chapter) that meets the requirements for participation under [subpart B of part 483](/cfr/42/part483-subpartB.md) 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
      - (B) If specified in the State plan, a swing-bed hospital that has an approval from CMS to furnish skilled nursing facility services in the Medicare program; and
    - (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](/cfr/42/part483-subpartB.md) 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](/cfr/42/part441-subpartB.md) of this chapter.)
- (c) **Family planning services and supplies for individuals of child-bearing age.** [Reserved]

## Notes

### Amendments

[59 FR 56233, Nov. 10, 1994; 60 FR 50117, Sept. 28, 1995, as amended at 61 FR 59198, Nov. 21, 1996; 68 FR 46071, Aug. 4, 2003]

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45224, Sept. 29, 1978, unless otherwise noted.

### Amendments

[59 FR 56233, Nov. 10, 1994; 60 FR 50117, Sept. 28, 1995, as amended at 61 FR 59198, Nov. 21, 1996; 68 FR 46071, Aug. 4, 2003]