410.77—Certified nurse-midwives' services: Qualifications and conditions.
(1)
Be a registered nurse who is legally authorized to practice as a nurse-midwife in the State where services are performed;
(2)
Have successfully completed a program of study and clinical experience for nurse-midwives that is accredited by an accrediting body approved by the U.S. Department of Education; and
(3)
Be certified as a nurse-midwife by the American College of Nurse-Midwives or the American College of Nurse-Midwives Certification Council.
(b) Services.
A certified nurse-midwife's services are services furnished by a certified nurse-midwife and services and supplies furnished as an incident to the certified nurse-midwife's services that—
(1)
Are within the scope of practice authorized by the law of the State in which they are furnished and would otherwise be covered if furnished by a physician or as an incident to a physician's service; and
(2)
Unless required by State law, are provided without regard to whether the certified nurse-midwife is under the supervision of, or associated with, a physician or other health care provider.
(c) Incident to services: Basic rule.
Medicare covers services and supplies furnished incident to the services of a certified nurse-midwife, including drugs and biologicals that cannot be self-administered, if the services and supplies meet the following conditions:
(1)
They would be covered if furnished by a physician or as incident to the professional services of a physician.
(2)
They are of the type that are commonly furnished in a physician's office and are either furnished without charge or are included in the bill for the certified nurse-midwife's services.
(3)
Although incidental, they are an integral part of the professional service performed by the certified nurse-midwife.
(4)
They are furnished under the direct supervision of a certified nurse-midwife (that is, the midwife is physically present and immediately available).
(d) Professional services.
A nurse-midwife can be paid for professional services only when the services have been performed personally by the nurse-midwife.
(1)
Supervision of other nonphysician staff by a nurse-midwife does not constitute personal performance of a professional service by the nurse-midwife.
(2)
The service is provided on an assignment-related basis, and a nurse-midwife may not charge a beneficiary for a service not payable under this provision. If the beneficiary has made payment for a service, the nurse-midwife must make the appropriate refund to the beneficiary.
(3)
A nurse-midwife may provide services that he or she is legally authorized to perform under State law as a nurse-midwife, if the services would otherwise be covered by the Medicare program when furnished by a physician or incident to a physicians' professional services.
[63 FR 58909, Nov. 2, 1998]