1. (1) Covered services. Professional and technical diagnostic services covered by MA are laboratory services provided by a certified physician or under the physician’s supervision, or prescribed by a prescribing provider and provided by an independent certified laboratory, and x-ray services prescribed by a prescribing provider and provided by or under the general supervision of a certified physician.

2. (2) Other limitations.

   1. (a) All diagnostic services shall be prescribed or ordered by a prescribing provider.
   2. (b) Laboratory tests performed which are outside the laboratory’s certified areas are not covered.
   3. (c) Portable x-ray services are covered only for recipients who reside in nursing homes and only when provided in a nursing home.
   4. (d) Reimbursement for diagnostic testing services shall be in accordance with limitations set by P.L. 98-369, Sec. 2303.

History

History: Cr. Register, February, 1986, No. 362, eff. 3-1-86; CR 25-055: am. (1), (2) (a) Register February 2026 No. 842, eff. 3-1-26.