10- 144 C.M.R. ch. 272, § VI-VI
Current through 2024-51, December 18, 2024
Prior authorized services through the C.C.S./C.S.H.N. Program are available for congenital anomalies of the genitourinary tract and other chronic genitourinary conditions to include but not limited to anomalies of vagina, chronic glomerulonephritis, extrophy of bladder and hypospadias as follows:
For those children who are referred by their primary care providers for subspecialty evaluation and/or treatment, the C.C.S./C.S.H.N. Program will pre-authorize payment for:
diagnostic evaluation/consultation by a pediatric urologist or nephrologist. This evaluation may include laboratory tests and related hospitalization costs; surgical components of the plan of care and related hospitalization costs upon receipt of the report of the evaluation; office visits with the pediatric urologist or nephrologist and related tests; and/or medications that require a written prescription for urinary tract infections as prescribed by the treating subspecialist.NON-COVERED GENITOURINARY SERVICES: dialysis and renal transplants.
10- 144 C.M.R. ch. 272, § VI-VI