Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 416.000 - Hearing Instrument Specialist Services
Section 416.407 - Individual Consideration

Universal Citation: 130 MA Code of Regs 130.416

Current through Register 1531, September 27, 2024

Services designated "I.C." in the list of service codes and descriptions in Subchapter 6 of the Hearing Instrument Specialist Manual are given individual consideration by the MassHealth agency to determine the amount of payment to be made to the hearing instrument specialist. The MassHealth agency determines the amount of payment using the following criteria:

(A) the time required to perform the procedure;

(B) the degree of skill required to perform the procedure;

(C) the severity or complexity of the member's hearing disorder or disability;

(D) the policies, procedures, and practices of other third-party purchasers of health care; and

(E) the reasonable and customary practices of hearing instrument specialists.

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