130 CMR, § 405.431
Current through Register 1538, January 3, 2025
The MassHealth agency only pays CHCs for those laboratory services listed in Subchapter 6 of the Community Health Center Manual. The MassHealth agency pays a CHC for laboratory services that are medically necessary for the diagnosis, treatment, and prevention of disease, and for the maintenance of the health of MassHealth members, subject to all the restrictions and limitations described in 130 CMR 405.000, and 450.000: Administrative and Billing Regulations. In order for a CHC to be paid for any laboratory service, a written request for that service from an authorized prescriber must be present in the member's medical record.
130 CMR, § 405.431