Title XVIII of the Social Security Act, §1861(r)(1) defines the term physician.
Title XVIII of the Social Security Act, §1861(s)(2)(A) defines medical and other health services and (K) addresses services which would be physicians' services if furnished by a physician and which are performed by a physician assistant, nurse practitioner or clinical nurse specialist.
Title XVIII of the Social Security Act, §1862(a)(1)(A) states that no payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body member and (a)(14) defines other than physician services.
42 CFR §410.32(a) indicates that diagnostic tests must be ordered by the treating physician, or other treating practitioner acting within the scope of his or her license and Medicare requirements, who uses the results in the management of the beneficiary's specific medical problem and (b)(3)(i-iii) defines supervision and the three levels of supervision.
42 CFR §410.74 defines physician assistants' services, §410.75 defines nurse practitioners' services and §410.76 defines clinical nurse specialists' services.
42 CFR §419.22 defines hospital services excluded from payment under the hospital outpatient prospective payment system.
CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §80 Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests.
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