Md. Code Regs. 10.09.87.04

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.87.04 - Covered Services

A. The Program covers medically necessary radiology services rendered to a recipient in an IDTF when the services are:

(1) Rendered in a CMS certified IDTF or an IDTF Mobile Unit;

(2) Provided according to the laws and regulations of the state and locality in which they are rendered;

(3) Rendered by a physician or supervised technician;

(4) Ordered in writing by the treating physician or non-physician practitioner, in accordance with State law, who is enrolled as a provider in the Program with an active status on the date of service; and

(5) Adequately documented in the recipient's medical record.

B. Radiology services include the following:

(1) Diagnostic X-rays;

(2) Computerized Tomography (CT) procedures;

(3) Magnetic Resonance Imaging (MRI);

(4) Magnetic Resonance Angiography (MRA);

(5) Nuclear medicine imaging and radionuclide used in the procedures;

(6) Diagnostic mammography and certain mammography screening;

(7) Ultrasound (US procedures);

(8) Position Emission Tomography (PET);

(9) Radiation oncology; and

(10) Bone mass measurements.

C. Magnetic Resonance Imaging (MRI), Computerized Tomography (CT), Nuclear Medicine Imaging to include Position Emission Tomography (PET) are covered only when billed by providers who are accredited by one of the following:

(1) The American College of Radiology;

(2) The Intersocietal Accreditation Commission; or

(3) The Joint Commission on Accreditation of Health Organizations (JCAHO).

Md. Code Regs. 10.09.87.04

Effective date: 41:8 Md. R. 472, eff.4/28/2014 ; amended effective 44:26 Md. R. 1214, eff. 1/1/2018