Exception to Limitation

20.1.2 - Exception to Limitation (Rev. 82; Issued: 02-08-08; Effective: 01-01-08; Implementation: 03-10-08) The limitation stated in section 20.1.1 does not apply to the following services: • Physicians’ professional services that meet the following conditions: o The services are personally furnished for an individual beneficiary by a physician; o The services contribute directly to the diagnosis or treatment of an individual beneficiary; o The services ordinarily require performance by a physician; o In the case of radiology or laboratory services, additional requirements in 42 CFR §415.120 and §415.130, respectively of the Code of Federal Regulations are met. • Physician assistant services, as defined in section 1861(s)(2)(K)(i) of the Social Security Act (the Act); • Nurse practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act; • Qualified psychologist services, as defined in section 1861(ii) of the Act; • Services of an anesthetist, as defined in regulations in 42 CFR 410.69; • Services furnished to SNF residents as defined in regulations in 42 CFR 411.15(p).