e-CFR data is current as of August 6, 2020
TITLE 42—Public Health
CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS PART 440—SERVICES: GENERAL PROVISIONS
Subpart A—DEFINITIONS
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| Specific definitions; definitions of services for FFP purposes. |
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| Inpatient hospital services, other than services in an institution for mental diseases. |
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| Outpatient hospital services and rural health clinic services. |
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| Other laboratory and X-ray services. |
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| Nursing facility services for individuals age 21 or older (other than services in an institution for mental disease), EPSDT, and family planning services and supplies. |
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| Physicians' services and medical and surgical services of a dentist. |
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| Medical or other remedial care provided by licensed practitioners. |
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| Private duty nursing services. |
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| Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders. |
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| Prescribed drugs, dentures, prosthetic devices, and eyeglasses. |
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| Diagnostic, screening, preventive, and rehabilitative services. |
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| Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions for mental diseases. |
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| Intermediate care facility (ICF/IID) services. |
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| Nursing facility services, other than in institutions for mental diseases. |
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| Inpatient psychiatric services for individuals under age 21. |
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| Nurse practitioner services. |
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| Primary care case management services. |
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| Case management services. |
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| Any other medical care or remedial care recognized under State law and specified by the Secretary. |
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| Home and community-based waiver services. |
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| Home and community-based services for individuals age 65 or older. |
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| State plan home and community-based services. |
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| Respiratory care for ventilator-dependent individuals. |
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Subpart B—REQUIREMENTS AND LIMITS APPLICABLE TO ALL SERVICES
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| Basis, purpose, and scope. |
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| Required services for the categorically needy. |
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| Required services for the medically needy. |
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| Sufficiency of amount, duration, and scope. |
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| Comparability of services for groups. |
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| Limits on comparability of services. |
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| Limited services available to certain aliens. |
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| Methods and standards to assure quality of services. |
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| Access and cultural considerations. |
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Subpart C—BENCHMARK BENEFIT AND BENCHMARK-EQUIVALENT COVERAGE
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| State plan requirements: Optional enrollment for exempt individuals. |
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| State plan requirements: Coverage and benefits. |
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| Benchmark health benefits coverage. |
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| Benchmark-equivalent health benefits coverage. |
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| Actuarial report for benchmark-equivalent coverage. |
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| EPSDT and other required benefits. |
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| Essential health benefits. |
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| Employer-sponsored insurance health plans. |
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| State plan requirements for providing additional services. |
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| Coverage of rural health clinic and federally qualified health center (FQHC) services. |
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| Delivery of benchmark and benchmark-equivalent coverage through managed care entities. |
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| Assurance of transportation. |
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| Parity in mental health and substance use disorder benefits. |
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