A general written report or a discharge summary must accompany the claim for payment for any service that is listed in Subchapter 6 of the Radiation Oncology Center Manual as requiring a report or individual consideration (I.C.), or if the code is for an unlisted service. This report must be sufficiently detailed to enable the MassHealth agency to assess the extent and nature of the service.

(436.409 through 436.412 Reserved)

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-5

Provider Manual Series (130 CMR 436.000)

Transmittal Letter Date

Radiation Oncology Center Manual

ROC-1 06/01/11