§ 405.2448 Preventive primary services.

(a) Preventive primary services are those health services that— (1) A FQHC is required to provide as preventive primary health services under section 330 of the PHS Act; and (2) Are furnished by a or under the direct supervision of a physician, nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, clinical social worker, marriage and family therapist, or mental health counselor employed by or under contract with the FQHC. (i) By a or under the direct supervision of a physician, nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, clinical social worker, marriage and family therapist, or mental health counselor; or (ii) By a member of the FQHC's health care staff who is an employee of the FQHC or by a physician under arrangements with the FQHC. (3) Except as specifically provided in section 1861(s) of the Act, include only drugs and biologicals that cannot be self-administered. (b) Preventive primary services which may be paid for when provided by FQHCs are the following: (1) Medical social services. (2) Nutritional assessment and referral. (3) Preventive health education. (4) Children's eye and ear examinations. (5) Prenatal and post-partum care. (6) Perinatal services. (7) Well child care, including periodic screening. (8) Immunizations, including tetanus-diptheria booster and influenza vaccine. (9) Voluntary family planning services. (10) Taking patient history. (11) Blood pressure measurement. (12) Weight. (13) Physical examination targeted to risk. (14) Visual acuity screening. (15) Hearing screening. (16) Cholesterol screening. (17) Stool testing for occult blood. (18) Dipstick urinalysis. (19) Risk assessment and initial counseling regarding risks. (20) Tuberculosis testing for high risk patients. (21) For women only. (i) Clinical breast exam. (ii) Referral for mammography; and (iii) Thyroid function test. (c) Preventive primary services do not include group or mass information programs, health education classes, or group education activities, including media productions and publications. (d) Screening mammography is not considered a FQHC service, but may be provided at a FQHC if the FQHC if the center meets the requirements applicable to that service specified in § 410.34 of this subchapter. Payment is made under applicable Medicare requirements. (e) Preventive primary services do not include eyeglasses, hearing aids, or preventive dental services.