130 CMR, § 424.405

Current through Register 1533, October 25, 2024
Section 424.405 - Noncovered Services

The MassHealth agency does not pay for the following:

(1) hygienic foot care as a separate procedure, except when the member's medical record documents that the member cannot perform the care or risks harming himself or herself by performing it. The preceding sentence notwithstanding, payment for hygienic foot care performed on a resident of a nursing facility is included in the nursing facility's per diem rate and is not reimbursable in any case as a separate procedure;
(2) canceled or missed appointments;
(3) services provided by a podiatrist whose contractual arrangements with a state institution, acute, chronic, or rehabilitation hospital, medical school, or other medical institution involve a salary, compensation in kind, teaching, research, or payment from any other sources, if such payment would result in dual compensation for professional, supervisory, or administrative services related to member care;
(4) telephone consultations;
(5) in-service education;
(6) research or experimental treatment;
(7) cosmetic services or devices;
(8) sneakers or athletic shoes;
(9) an additional charge for nonstandard size (width or length) in custom-molded shoes; or (10) shoes when there is no diagnosis of associated foot deformities.

130 CMR, § 424.405

Amended by Mass Register Issue 1319, eff. 8/12/2016.