Radiology services are professional and technical radiological services – (a) ordered and provided by or under the direction of a physician or other licensed practitioner of the healing arts within the scope of his practice as defined by state law; (b) provided in an office or similar facility other than a hospital outpatient department or clinic; and (c) provided by a radiology facility that meets the requirements for participation in Medicare.

1. (1) Radiology services are restricted to those that are described by procedures in the CPT manual (70010-79999) or one of the locally assigned HCPCS codes used only by Medicaid to supplement the listing in the CPT manual.
2. (2) Providers will be paid only for covered services which they are certified to perform and which they actually perform.

Author: Alabama Medicaid Agency

Statutory Authority: State Plan; Title XIX, Social Security Act; 42 C.F.R. Section 440.30.

History: New Rule: Filed September 8, 1998; effective October 13, 1998.