890.702—Payment to any licensed practitioner.

(a) Except as provided in paragraph (b) of this section, if a contract between the Office of Personnel Management and a group health insurance carrier offering a health benefits plan subject to this subpart provides for payment or reimbursement of the cost of health services for the care and treatment of a particular health condition only if such service is rendered by a certain category of practitioner, the plan must also provide benefits, up to the limits of it contract, for the same service when rendered and billed for by any other individual who is licensed under applicable State law to provide such service, if the service is provided to an enrollee of the plan in a medically underserved area as defined by this subpart.
(b) Paragraph (a) of this section applies only to health services provided under contracts which became effective after December 31, 1979.

Code of Federal Regulations

[45 FR 48099, July 18, 1980, as amended at 52 FR 2666, Jan. 26, 1987]