42 CFR 460.92
§ 460.92 Required services.
United States · 42 CFR — Public Health · Status: effective
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- Citation
- 42 CFR 460.92, § 460.92 Required services, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/206972
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Full text
(a) The PACE benefit package for all participants, regardless of the source of payment, must include the following:
(1) All Medicare-covered services.
(2) All Medicaid-covered services, as specified in the State's approved Medicaid plan.
(3) Other services determined necessary by the interdisciplinary team to improve and maintain the participant's overall health status.
(b) Decisions by the interdisciplinary team to provide or deny services under paragraph (a) of this section must be based on an evaluation of the participant that takes into account:
(1) The participant's current medical, physical, emotional, and social needs; and
(2) Current clinical practice guidelines and professional standards of care applicable to the particular service.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.