C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 440—SERVICES: GENERAL PROVISIONS › Subpart A—Definitions

42 C.F.R. § 440.130

Diagnostic, screening, preventive, and rehabilitative services

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(a) “Diagnostic services,” except as otherwise provided under this subpart, includes any medical procedures or supplies recommended by a physician or other licensed practitioner of the healing arts, within the scope of his practice under State law, to enable him to identify the existence, nature, or extent of illness, injury, or other health deviation in a beneficiary.

(b) “Screening services” means the use of standardized tests given under medical direction in the mass examination of a designated population to detect the existence of one or more particular diseases or health deviations or to identify for more definitive studies individuals suspected of having certain diseases.

(c) “Preventive services” means services recommended by a physician or other licensed practitioner of the healing arts acting within the scope of authorized practice under State law to—

(1) Prevent disease, disability, and other health conditions or their progression;

(2) Prolong life; and

(3) Promote physical and mental health and efficiency.

(d) “Rehabilitative services,” except as otherwise provided under this subpart, includes any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts, within the scope of his practice under State law, for maximum reduction of physical or mental disability and restoration of a beneficiary to his best possible functional level.

[43 FR 45224, Sept. 29, 1978, as amended at 78 FR 42306, July 15, 2013]
Notes of Decisions
Cited in 16 cases (3 in the last 5 years), 1985–2026 · leading case: Parents League for Effective Autism Servs. v. Jones-Kelley, 565 F. Supp. 2d 905 (S.D. Ohio 2008).
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Parents League for Effective Autism Servs. v. Jones-Kelley, 565 F. Supp. 2d 905 (S.D. Ohio 2008). · cites it 2× “” See 42 C.F.R. § 440.130 (d). The federal regulations do not require that the rehabilitative services reduce “mental illness.”
K.G. ex rel. Garrido v. Dudek, 839 F. Supp. 2d 1254 (S.D. Fla. 2011). · cites it 2× “42 C.F.R. § 440.130 (d) (emphasis added).”
Gary Dube & a. v. New Hampshire Dep't of Health & Human Servs. & a., 166 N.H. 358 (N.H. 2014). “§§ 1396a(a)(10)(A)(ii), 1396d(a)(13); 42 C.F.R. § 440.130 (d) (2013). DHHS is also responsible for establishing, maintaining, and coordinating “a comprehensive, effective, and efficient system of services for persons with mental illness.”
K.G. ex rel. Garrido v. Dudek, 864 F. Supp. 2d 1314 (S.D. Fla. 2012). “42 C.F.R. § 440.130 (d) (emphasis added).”
Fred C. v. Texas Health & Human Servs. Com'n, 988 F. Supp. 1032 (W.D. Tex. 1997). “” 42 C.F.R. § 440.130 (d) (1996). In order for Fred C.”
Ohio v. United States Dep't of Health & Human Servs., 761 F.2d 1187 (6th Cir. 1985). · cites it 2× “42 C.F.R. § 440.130 (d) (1984). In its plan amendment Ohio referred to § 1396d(a)(13) and sought approval for rehabilitative services.”
Fred C. Ex Rel. Tattin v. Texas Health & Human Servs. Comm'n, 924 F. Supp. 788 (W.D. Tex. 1996). “” 42 C.F.R. § 440.130 (d) (1995). In order for Fred C.”
K.G. ex rel. Garrido v. Dudek, 981 F. Supp. 2d 1275 (S.D. Fla. 2013). · cites it 2× “42 C.F.R. § 440.130 (d) (emphasis added).”
Parents' League for Effective Autism Servs. v. Jones-Kelley, 339 F. App'x 542 (6th Cir. 2009). “42 C.F.R. § 440.130 (d). In a section dealing with state waiver programs, the Medicaid Act defines "habilitative services” as: services designed to assist individuals in acquiring, retaining, and improving the self-help, socialization, and adaptive skills necessary to reside…”
Parents League for Effective Autism Servs. v. Jones-Kelley, 565 F. Supp. 2d 895 (S.D. Ohio 2008). “” See 42 C.F.R. § 440.130 (d). The federal regulations do not require that the rehabilitative service reduce “mental illness.”
Gabai v. Grinker, 148 Misc. 2d 359 (N.Y. Sup. Ct. 1990). “” (42 CFR 440.130 [c], [d].) The only evidence presented at the fair hearing was that Mr.”
Peer Assocs. LLC v. DHS (Pa. Commw. Ct. 2023). “§ 1396d(a); 42 CFR § 440.130 . Pennsylvania’s MA program’s mandatory behavioral health managed care delivery system is known as the HealthChoices Behavioral Health Program (HealthChoices BH Program).”
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