130 C.M.R. 433.000 – Physician Services | Midpage

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Code of Massachusetts Regulations (CMR)

Chapter 433.000

130 C.M.R. 433.000

Physician Services

M.G.L. c. 118E, s. 7 M.G.L. c. 118E, s. 12MassHealth

433.401Definitions 433.402Eligible Members 433.403Provider Eligibility 433.404Nonpayable Circumstances 433.405Maximum Allowable Fees 433.406Individual Consideration 433.407Service Limitations: Professional and Technical Components of Services and Procedures 433.408Prior Authorization, Orders, Referrals, and Prescriptions 433.409Recordkeeping (Medical Records) Requirements 433.410Report Requirements 433.411Child and Adolescent Needs and Strengths (CANS) Data Reporting 433.412Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services 433.413Office Visits: Payment Limitations 433.414Outpatient Hospital Services: Payment Limitations 433.415Inpatient Hospital Services: Service Limitations and Screening Requirements 433.416Nursing Facility Visits: Service Limitations 433.417Home Visits: Service Limitations 433.418Consultations: Service Limitations 433.419Certified Nurse Midwife Services 433.420Obstetric Services: Introduction 433.421Obstetric Services: Global-Fee Method of Payment 433.424Obstetric Services: Fee-for-Service Method of Payment 433.425Ophthalmology Services 433.426Audiology Services: Service Limitations 433.427Allergy Testing: Service Limitations 433.428Psychiatric Services: Introduction 433.429Psychiatric Services: Scope of Services 433.430Dialysis: Service Limitations 433.431Physical Medicine: Service Limitations 433.432Other Medical Procedures 433.433Certified Nurse Practitioner Services 433.434Physician Assistant Services 433.435Tobacco Cessation Services 433.436Radiology Services: Introduction 433.437Radiology Services: Service Limitations 433.438Clinical Laboratory Services: Introduction 433.439Clinical Laboratory Services: Service Limitations 433.440Acupuncture 433.441Pharmacy Services: Drugs Dispensed in Pharmacies 433.447Drugs Administered in the Office (Provider-administered Drugs)433.449Fluoride Varnish Services 433.451Surgery Services: Introduction 433.452Surgery Services: Payment 433.454Anesthesia Services 433.455Abortion Services 433.456Sterilization Services: Introduction 433.457Sterilization Services: Informed Consent 433.458Sterilization Services: Consent Form Requirements 433.459Hysterectomy Services 433.473Clinical Nurse Specialist (CNS) Services.433.485CARES Program Services