- (A) Some services listed in Subchapter 6 of the Oxygen and Respiratory Therapy Equipment Manual are designated “I.C.”, an abbreviation for individual consideration. Individual consideration means that a fee could not be established by the Division of Health Care Finance and Policy. The payment for an individual-consideration service will be determined by the Division’s professional advisors. Before making a determination, the Division's professional advisors will analyze the provider’s report of services submitted, the cost of constructing or adapting the device, and the adjusted acquisition cost of the materials.
- (B) Providers must maintain adequate records to determine the appropriateness of individual- consideration claims and must provide these documents to the Division upon demand. Payment to a provider for an individual-consideration claim shall be in accordance with 130 CMR 427.000.
Commonwealth of Massachusetts Subchapter Number and Title Page
MassHealth 4. Program Regulations
4-9
Provider Manual Series (130 CMR 427.000)
Transmittal Letter Date
Oxygen and Respiratory Therapy
Equipment Manual
OXY-35 04/28/23