Title 42, Part 410 — Supplementary Medical Insurance (Smi) Benefits
96 sections
Section 410.1
Basis and scope.
Section 410.2
Definitions.
Section 410.3
Scope of benefits.
Section 410.5
Other applicable rules.
Section 410.10
Medical and other health services: Included services.
Section 410.12
Medical and other health services: Basic conditions and limitations.
Section 410.14
Special requirements for services furnished outside the United States.
Section 410.15
Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage.
Section 410.16
Initial preventive physical examination: Conditions for and limitations on coverage.
Section 410.17
Cardiovascular disease screening tests.
Section 410.18
Diabetes screening tests.
Section 410.19
Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage.
Section 410.20
Physicians' services.
Section 410.21
Limitations on services of a chiropractor.
Section 410.22
Limitations on services of an optometrist.
Section 410.23
Screening for glaucoma: Conditions for and limitations on coverage.
Section 410.24
Limitations on services of a doctor of dental surgery or dental medicine.
Section 410.25
Limitations on services of a podiatrist.
Section 410.26
Services and supplies incident to a physician's professional services: Conditions.
Section 410.27
Therapeutic outpatient hospital or CAH services and supplies incident to a physician's or nonphysician practitioner's service: Conditions.
Section 410.28
Hospital or CAH diagnostic services furnished to outpatients: Conditions.
Section 410.29
Limitations on drugs and biologicals.
Section 410.30
Prescription drugs used in immunosuppressive therapy.
Section 410.31
Bone mass measurement: Conditions for coverage and frequency standards.
Section 410.32
Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.
Section 410.33
Independent diagnostic testing facility.
Section 410.34
Mammography services: Conditions for and limitations on coverage.
Section 410.35
X-ray therapy and other radiation therapy services: Scope.
Section 410.36
Medical supplies, appliances, and devices: Scope.
Section 410.37
Colorectal cancer screening tests: Conditions for and limitations on coverage.
Section 410.38
Durable medical equipment, prosthetics, orthotics and supplies (DMEPOS): Scope and conditions.
Section 410.39
Prostate cancer screening tests: Conditions for and limitations on coverage.
Section 410.40
Coverage of ambulance services.
Section 410.41
Requirements for ambulance providers and suppliers.
Section 410.42
Limitations on coverage of certain services furnished to hospital outpatients.
Section 410.43
Partial hospitalization services: Conditions and exclusions.
Section 410.44
Intensive outpatient services: Conditions and exclusions.
Section 410.45
Rural health clinic services: Scope and conditions.
Section 410.46
Physician and other practitioner services furnished in or at the direction of an IHS or Indian tribal hospital or clinic: Scope and conditions.
Section 410.47
Pulmonary rehabilitation program: Conditions for coverage.
Section 410.48
Kidney disease education services.
Section 410.49
Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.
Section 410.50
Institutional dialysis services and supplies: Scope and conditions.
Section 410.52
Home dialysis services, supplies, and equipment: Scope and conditions.
Section 410.53
Marriage and family therapist services.
Section 410.54
Mental health counselor services.
Section 410.55
Services related to kidney donations: Conditions.
Section 410.56
Screening pelvic examinations.
Section 410.57
Preventive vaccines.
Section 410.58
Additional services to HMO and CMP enrollees.
Section 410.59
Outpatient occupational therapy services: Conditions.
Section 410.60
Outpatient physical therapy services: Conditions.
Section 410.61
Plan of treatment requirements for outpatient rehabilitation services.
Section 410.62
Outpatient speech-language pathology services: Conditions and exclusions.
Section 410.63
Hepatitis B vaccine and blood clotting factors: Conditions.
Section 410.64
Additional preventive services.
Section 410.66
Emergency outpatient services furnished by a nonparticipating hospital and services furnished in a foreign country.
Section 410.67
Medicare coverage and payment of Opioid use disorder treatment services furnished by Opioid treatment programs.
Section 410.68
Antigens: Scope and conditions.
Section 410.69
Services of a certified registered nurse anesthetist or an anesthesiologist's assistant: Basic rule and definitions.
Section 410.71
Clinical psychologist services and services and supplies incident to clinical psychologist services.
Section 410.72
Registered dietitians' and nutrition professionals' services.
Section 410.73
Clinical social worker services.
Section 410.74
Physician assistants' services.
Section 410.75
Nurse practitioners' services.
Section 410.76
Clinical nurse specialists' services.
Section 410.77
Certified nurse-midwives' services: Qualifications and conditions.
Section 410.78
Telehealth services.
Section 410.79
Medicare Diabetes Prevention Program expanded model: Conditions of coverage.
Section 410.80
Applicable rules.
Section 410.100
Included services.
Section 410.102
Excluded services.
Section 410.105
Requirements for coverage of CORF services.
Section 410.110
Requirements for coverage of partial hospitalization services by CMHCs.
Section 410.111
Requirements for coverage of intensive outpatient services in CMHCs.
Section 410.130
Definitions.
Section 410.132
Medical nutrition therapy.
Section 410.134
Provider qualifications.
Section 410.140
Definitions.
Section 410.141
Outpatient diabetes self-management training.
Section 410.142
CMS process for approving national accreditation organizations.
Section 410.143
Requirements for approved accreditation organizations.
Section 410.144
Quality standards for deemed entities.
Section 410.145
Requirements for entities.
Section 410.146
Diabetes outcome measurements.
Section 410.150
To whom payment is made.
Section 410.152
Amounts of payment.
Section 410.155
Outpatient mental health treatment limitation.
Section 410.160
Part B annual deductible.
Section 410.161
Part B blood deductible.
Section 410.163
Payment for services furnished to kidney donors.
Section 410.165
Payment for rural health clinic services and ambulatory surgical center services: Conditions.
Section 410.170
Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive outpatient rehabilitation facility (CORF) services: Conditions.
Section 410.172
Payment for partial hospitalization services in CMHCs: Conditions.
Section 410.173
Payment for intensive outpatient services in CMHCs: Conditions.
Section 410.175
Alien absent from the United States.