42 C.F.R. § 405.2463 What constitutes a visit.
Title 42 - Public Health
(a) Visit. (1) A visit is a face-to-face encounter between a clinic or center patient and a physician, physician assistant, nurse practitioner, nurse-midwife, or visiting nurse. (2) For FQHCs, a visit also means a face-to-face encounter between a patient and a qualified clinical psychologist or clinical social worker. (3) Encounters with more than one health professional and multiple encounters with the same health professional that take place on the same day and at a single location constitute a single visit, except when one of the following conditions exist: (i) After the first encounter, the patient suffers illness or injury requiring additional diagnosis or treatment. (ii) For FQHCs, the patient has a medical visit and an other health visit, as defined in paragraphs (b) and (c) of this section. (4) Payment. (i) Medicare pays for two visits per day when the conditions in paragraph (a)(3) of this section are met. (ii) In all other cases, payment is limited to one visit per day. (b) Medical visit. For purposes of paragraph (a)(3) of this section, a medical visit is a face-to-face encounter between an FQHC patient and a physician, physician assistant, nurse practitioner, nurse-midwife, or visiting nurse. (c) Other health visit. For purposes of paragraph (a)(3) of this section, an other health visit is a face-to-face encounter between an FQHC patient and a clinical psychologist, clinical social worker, or other health professional for mental health services. [61 FR 14657, Apr. 3, 1996]
Title 42: Public Health
PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
Subpart X—Rural Health Clinic and Federally Qualified Health Center Services
Payment for Rural Health Clinic and Federally Qualified Health Center Services
§ 405.2463 What constitutes a visit.
