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    <FDSYS>
        <CFRTITLE>42</CFRTITLE>
        <CFRTITLETEXT>Public Health</CFRTITLETEXT>
        <VOL>4</VOL>
        <DATE>2025-10-01</DATE>
        <COVERONLY>false</COVERONLY>
        <ORIGINALDATE>2025-10-01</ORIGINALDATE>
        <ANCESTORS>
            <PARENT HEADING="Title 42" SEQ="4">Public Health</PARENT>
            <PARENT HEADING="CHAPTER IV" SEQ="3">CENTERS FOR MEDICARE &amp; MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED)</PARENT>
            <PARENT HEADING="SUBCHAPTER C" SEQ="2">MEDICAL ASSISTANCE PROGRAMS</PARENT>
            <PARENT HEADING="PART 440" SEQ="1">SERVICES: GENERAL PROVISIONS</PARENT>
            <PARENT HEADING="Subpart A" SEQ="0">Definitions</PARENT>
        </ANCESTORS>
    </FDSYS>
    <SECTION>
        <SECTNO>§ 440.40</SECTNO>
        <SUBJECT>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.</SUBJECT>
        <P>
            (a) 
            <E T="03">Nursing facility services.</E>
             (1) “Nursing facility services for individuals age 21 or older, other than services in an institution for mental diseases”, means services that are—
        </P>
        <P>
            (i) Needed on a daily basis and required to be provided on an inpatient 
            <PRTPAGE P="395"/>
            basis under §§ 409.31 through 409.35 of this chapter.
        </P>
        <P>(ii) Provided by—</P>
        <P>(A) A facility or distinct part (as defined in § 483.5(b) of this chapter) that meets the requirements for participation under subpart B of part 483 of this chapter, as evidenced by a valid agreement between the Medicaid agency and the facility for providing nursing facility services and making payments for services under the plan; or</P>
        <P>(B) If specified in the State plan, a swing-bed hospital that has an approval from CMS to furnish skilled nursing facility services in the Medicare program; and</P>
        <P>(iii) Ordered by and provided under the direction of a physician.</P>
        <P>(2) Nursing facility services include services provided by any facility located on an Indian reservation and certified by the Secretary as meeting the requirements of subpart B of part 483 of this chapter.</P>
        <P>
            (b) 
            <E T="03">EPSDT.</E>
             “Early and periodic screening and diagnosis and treatment” means—
        </P>
        <P>(1) Screening and diagnostic services to determine physical or mental defects in beneficiaries under age 21; and</P>
        <P>(2) Health care, treatment, and other measures to correct or ameliorate any defects and chronic conditions discovered. (See subpart B of part 441 of this chapter.)</P>
        <P>
            (c) 
            <E T="03">Family planning services and supplies for individuals of child-bearing age.</E>
             [Reserved]
        </P>
        <CITA>[59 FR 56233, Nov. 10, 1994; 60 FR 50117, Sept. 28, 1995, as amended at 61 FR 59198, Nov. 21, 1996; 68 FR 46071, Aug. 4, 2003]</CITA>
    </SECTION>
</CFRGRANULE>
