C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS › Subpart E—Services of Residents

42 C.F.R. § 415.200

Services of residents in approved GME programs

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(a) General rules. Services furnished in hospitals by residents in approved GME programs are specifically excluded from being paid as “physician services” defined in § 414.2 of this chapter and are payable as hospital services. This exclusion applies whether or not the resident is licensed to practice under the laws of the State in which he or she performs the service. The payment methodology for services of residents in hospitals and hospital-based providers is set forth in §§ 413.75 through 413.83 of this chapter.

(b) Exception. For low and mid-level evaluation and management services furnished under certain conditions in centers located in hospital outpatient departments and other ambulatory settings, see § 415.174.

(c) Definitions. See § 415.152 for definitions of terms used in this subpart E.

[60 FR 63178, Dec. 8, 1995, as amended at 70 FR 47490, Aug. 12, 2005]
Notes of Decisions
Cited in 1 case, 2009–2009 · leading case: Medcenter One Health Sys. v. Leavitt, 666 F. Supp. 2d 1043 (D.N.D. 2009).
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Medcenter One Health Sys. v. Leavitt, 666 F. Supp. 2d 1043 (D.N.D. 2009). “§§ 1395x(b)(6) (2000) and 1395x(q) (2000); 42 C.F.R. §§ 415.200 (2000) and 415.206 (2000).”
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