Medicare General Information, Eligibility and Entitlement Manual (Pub. 100-01), Ch. 5 § 10
Part A Provider and Related Definitions
10 - Part A Provider and Related Definitions
(Rev. 12425, Issued: 12-21-23, Effective: 01-01-24, Implementation: 01-02-24)
Section 1866(e) of the Social Security Act defines the term "provider of
services" (or provider) as:
(1)
A clinic, rehabilitation agency, or public health agency if, in the case
of a clinic or rehabilitation agency, such clinic or agency meets the
requirements of
section 1861(p)(4)(A) (or meets the requirements of such section through the
operation of section 1861(g)), or if, in the case of a public health agency, such
agency meets the requirements of section 1861(p)(4)(B) (or meets the
requirements of such section through the operation of section 1861(g)), but
only with respect to the furnishing of outpatient physical therapy services (as
therein defined) or (through the operation of section 1861(g)) with respect to
the furnishing of outpatient occupational therapy services; and
(2)
A community mental health center (as defined in section
1861(ff)(3)(B)), but only with respect to the furnishing of partial
hospitalization services (as described in section 1861(ff)(1)) or intensive
outpatient services (as described in section 1861(ff)(4)). Definitions of
providers, physicians, practitioners, and suppliers, and a description of the
requirements that each must meet in order for their services to be considered
covered are described in the following sections.