---
kind: "section"
citation: "42 C.F.R. § 447.25"
title: "42"
number: "447.25"
heading: "Direct payments to certain beneficiaries for physicians' or dentists' services."
url: "https://uscodex.org/cfr/42/447.25"
---

# §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)](#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.**
- (c) **Federal financial participation.** No FFP is available in expenditures for direct payment for physicians' or dentists' services to any beneficiary—
  - (1) Who is receiving assistance under the State's approved plan under title I, IV-A, X, XIV or XVI (AABD) of the Act; or
  - (2) To whom supplemental security benefits are being paid under title XVI of the Act; or
  - (3) Who is receiving or eligible for a State supplementary payment or would be eligible if he were not in a medical institution, and who is eligible for Medicaid as a categorically needy beneficiary.
- (d) **Federal requirements.**
  - (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.

## Notes

### Authority

Authority: 42 U.S.C. 1302, and 1396r-8, and Pub. L. 111-148.

### Source

Source: 43 FR 45253, Sept. 29, 1978, unless otherwise noted.