130 C.M.R. 431.401
Commonwealth of Massachusetts Subchapter Number and Title Page
MassHealth
Table of Contents iv
Provider Manual Series
Transmittal Letter Date
Independent Diagnostic Testing
Facility Manual
IDTF-1 07/01/06
4. Program Regulations
431.401: Introduction .......................................................................................................... 4-1 431.402: Definitions ............................................................................................................ 4-1 431.403: Eligible Members ................................................................................................. 4-2 431.404: Provider Eligibility ................................................................................................ 4-2 431.405: Maximum Allowable Fees .................................................................................... 4-3 431.406: Individual Consideration ....................................................................................... 4-3 431.407: Prior Authorization................................................................................................ 4-4 431.408: Separate Procedures .............................................................................................. 4-4 431.409: Ordering of Tests................................................................................................... 4-4 431.410: Payment ................................................................................................................. 4-5 431.411: Service Descriptions and Limitations: Levels of Physician Supervision ............. 4-5 431.412: Service Descriptions and Limitations: Sleep Centers........................................... 4-5 431.413: Covered Services................................................................................................... 4-5 431.414: Noncovered Services ............................................................................................. 4-5 431.415: Recordkeeping Requirements................................................................................ 4-6
Commonwealth of Massachusetts Subchapter Number and Title Page
MassHealth 4. Program Regulations
4-1
Provider Manual Series (130 CMR 431.000)
Transmittal Letter Date
Independent Diagnostic Testing
Facility Manual
IDTF-16 09/09/16
130 CMR 431.000 establishes the requirements for the provision and reimbursement of
independent diagnostic testing facility services under MassHealth. The MassHealth agency pays for independent diagnostic testing facility services that are medically necessary and appropriately provided in accordance with 130 CMR 450.204. All IDTF providers participating in MassHealth must comply with all MassHealth regulations including, but not limited to, 130 CMR 431.000 and 450.000: Administrative and Billing Regulations.