Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth

Table of Contents iv

Provider Manual Series

Transmittal Letter Date

Independent Clinical Laboratory Manual

LAB-35 04/01/10

4. Program Regulations

401.401: Introduction .......................................................................................................... 4-1 401.402: Definitions ............................................................................................................ 4-1 401.403: Eligible Members ................................................................................................. 4-2 401.404: Provider Eligibility ............................................................................................... 4-2 401.405: Laboratory Services Provided outside of Massachusetts ..................................... 4-3 (130 CMR 401.406 through 401.409 Reserved) 401.410: Covered Services .................................................................................................. 4-4 401.411: Noncovered Services and Payment Limitations.................................................... 4-4 401.412: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services ........ 4-4 (130 CMR 401.413 and 401.414 Reserved) 401.415: Specimen Referral ................................................................................................ 4-5 401.416: Request for Laboratory Services .......................................................................... 4-5 401.417: Recordkeeping Requirements ............................................................................... 4-6 401.418: Maximum Allowable Fees ................................................................................... 4-7 401.419: Individual Consideration ...................................................................................... 4-7 401.420: Panel Tests ............................................................................................................ 4-8 401.421: Quality Assurance and Provider Review .............................................................. 4-8

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-1

Provider Manual Series (130 CMR 401.000)

Transmittal Letter Date

Independent Clinical Laboratory Manual

LAB-38 01/01/12