Section 433.407 - Service Limitations: Professional and Technical Components of Services and ProceduresAdditional limitations are set forth in 130 CMR 433.413 and 433.437.
(A)Definitions. (1)Professional Component - the component of a service or procedure representing the physician's work interpreting or performing the service or procedure.(2)Technical Component - the component of a service or procedure representing the cost of rent, equipment, utilities, supplies, administrative and technical salaries and benefits, and other overhead expenses of the service or procedure, excluding the physician's professional component.(B)Payment. A physician may bill for the professional component of a service or procedure or, subject to the conditions of payment set forth in 130 CMR 433.407(C), both the professional and technical components of the service or procedure. The MassHealth agency does not pay a physician for providing the technical component only of a service or procedure.(C)Conditions of Payment for the Provision of Both the Professional and Technical Components of a Service or Procedure. Only the physician providing the professional component of the service or procedure may bill for both the professional and technical components. This constitutes a limited exception to 130 CMR 450.301: Claims. A physician may bill for providing both the professional and technical components of a service or procedure in the physician's office when the physician owns or leases the equipment used to perform the service or procedure, provides the technical component (either directly or by employing a technician), and provides the professional component.Amended by Mass Register Issue S1277, eff. 1/2/2015.Amended by Mass Register Issue S1345, eff. 8/11/2017.Amended by Mass Register Issue 1461, eff. 1/21/2022.