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. § 440.50

Physicians' services and medical and surgical services of a dentist

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(a) “Physicians' services,” whether furnished in the office, the beneficiary's home, a hospital, a skilled nursing facility, or elsewhere, means services furnished by a physician—

(1) Within the scope of practice of medicine or osteopathy as defined by State law; and

(2) By or under the personal supervision of an individual licensed under State law to practice medicine or osteopathy.

(b) “Medical and surgical services of a dentist” means medical and surgical services furnished, on or after January 1, 1988, by a doctor of dental medicine or dental surgery if the services are services that—

(1) If furnished by a physician, would be considered physician's services.

(2) Under the law of the State where they are furnished, may be furnished either by a physician or by a doctor of dental medicine or dental surgery; and

(3) Are furnished by a doctor of dental medicine or dental surgery who is authorized to furnish those services in the State in which he or she furnished the services.

[56 FR 8851, Mar. 1, 1991]
Notes of Decisions
Cited in 9 cases (1 in the last 5 years), 1979–2021 · leading case: Yapalater v. Bates, 494 F. Supp. 1349 (S.D.N.Y. 1980).
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Yapalater v. Bates, 494 F. Supp. 1349 (S.D.N.Y. 1980). · cites it 2× “9 Central to the present case is the regulation appearing at 42 C.F.R. § 440.50 , which HHS states in its letter to the Court was promulgated by the Secretary “to define physicians’ services.”
Cruz v. Zucker, 195 F. Supp. 3d 554 (S.D.N.Y. 2016). “70”), For instance, 42 C.F.R. § 440.50 (a) defines “physicians’ services” as “services furnished by a physician .”
Katz v. New Mexico Dep't of Human Servs., 624 P.2d 39 (N.M. 1981). “Katz points to the regulations promulgated by HEW under the act which define physicians’ services as services provided “[wjithin the scope of practice of medicine or osteopathy as defined by State law ____” 42 C.F.R. § 440.50 (1979). Katz argues that, under state law, the…”
Cruz v. Zucker, 116 F. Supp. 3d 334 (S.D.N.Y. 2015). “” 42 C.F.R. § 440.50 (a). The implementing regulations further provide, in relevant part: (b) Each service must be sufficient in amount, duration, and scope to reasonably achieve its purpose.”
Simpson v. Wilson, 480 F. Supp. 97 (D. Vt. 1979). “42 C.F.R. § 440.50 (1978). Moreover: The plan must provide for payment of optometric services as physician services, whether furnished by an optometrist or a physician, if— (a) The plan does not provide for payment for services provided by an optometrist, except for eligibility…”
Warr v. Horsley, 705 F. Supp. 540 (M.D. Ala. 1989). · cites it 2× “The defendant contends that podiatrists are outside the scope of mandatory services because the only category they could possibly be covered by is “physicians’ services furnished by a physician,” and “physicians’ services” are defined under 42 C.F. R. § 440.50 as those “by or…”
Nichols v. Off. of Med. Assistance Programs, 15 P.3d 578 (Or. Ct. App. 2000). “See 42 CFR § 440.50 . OMAP’s reasoning is also inconsistent with the few relevant federal cases.”
Wheeling Hosp. v. Charles O. Lorensen, WV Tax Comm., 742 S.E.2d 86 (W. Va. 2013). · cites it 7× “” See 42 C.F.R. § 440.50 (a)(1), (2) (2012). Acknowledging that “what the doctor does and what the hospital does (and provides to the doctor) must be considered, construed, and treated as two different things,” the circuit court reasoned that the Hospital’s provision of its…”
Ronald Goldman & 27 Other Taxpayers v. Sec'y of the Exec. Off. of Health & Human Servs. (Mass. Super. Ct. 2021). “§§ 1396a(10)(A); 1396d(a)(5); 1395x(q); see also 42 C.F.R. § 440.50 (defining “physicians’ services” as services “furnished by a physician — (1) Within the scope of practice of medicine or osteopathy as defined by State law; and (2) By or under the personal supervision of an…”
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