§ 1129.2. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
Certified registered nurse practitioner—A registered nurse licensed in this Commonwealth who is currently certified by the State Board of Medicine and the State Board of Nursing as a certified registered nurse practitioner and who meets the qualifications for a nurse practitioner as set forth at 42 CFR 481.2(b).
Covered service—A benefit to which a MA recipient is entitled under the Medical Assistance program.
Independent rural health clinic—A clinic that:(i) Meets the requirements for participation in the MA Program as set forth at 42 CFR 481.1.
(ii) Is not part of a hospital, skilled nursing facility or home health agency.
Nurse midwife—A registered nurse licensed in this Commonwealth who is currently certified by the State Board of Medicine to practice midwifery.
Physician—An individual licensed to practice medicine and surgery under section 10 of the Medical Practice Act of 1974 (63 P. S. § 421.10) (Repealed) or the Osteopathic Medical Practice Act (63 P. S. § § 271.1—271.18).
Physician assistant—An individual currently certified as a physician assistant by the State Board of Medicine or by the State Board of Osteopathic Medicine and who meets the qualifications for a physician assistant as set forth at 42 CFR 481.2(d).
Provider rural health clinic—A clinic that:(i) Meets the requirements for participation in the MA Program as set forth at 42 CFR 481.1.
(ii) Is an integral part of a hospital, skilled nursing facility or home health agency.
Registered nurse—An individual licensed in this Commonwealth by the State Board of Nursing to practice professional nursing.
Rural health clinic personnel—A physician, certified registered nurse practitioner, registered nurse, nurse midwife or physician assistant who by contract or agreement with a rural health clinic provides medical services for the rural health clinic.
Rural health clinic service—A service provided by rural health clinic personnel or an item furnished incident to services provided by rural health clinic personnel the cost of which is included in allowable costs for Medicare purposes under the Medicare program as set forth at 42 CFR 405.2401—405.2430.
Visit—Face-to-face encounter between a clinic patient and a physician, physician assistant, nurse practitioner, nurse midwife, specialized nurse practitioner or visiting nurse for the purpose of receiving medical services. Encounters with more than one health professional and multiple encounters with the same health professional which take place on the same day and at a single location constitute a single visit, except for cases in which the patient, subsequent to the first encounter, suffers illness or injury requiring additional diagnosis or treatment.
Source The provisions of this § 1129.2 adopted December 5, 1980, effective December 1, 1980, 10 Pa.B. 4597; amended December 23, 1983, effective January 1, 1983, 13 Pa.B. 3932. Immediately preceding text appears at serial pages (58109) to (58110).
Cross References This section cited in 55 Pa. Code § 1129.53 (relating to payment policy for independent rural health clinics).
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