Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 420.000 - Dental Services
Section 420.412 - Individual Consideration
Current through Register 1531, September 27, 2024
(A) Certain services, including unspecified procedures, are designated "IC" (individual consideration) in Subchapter 6 of the Dental Manual and in the EOHHS pricing regulation for dental services, 101 CMR 314.00: Dental Services. This means that a fee could not be established for these services. The MassHealth agency determines appropriate payment for individual-consideration services from the provider's detailed report of services provided (see Subchapter 6 of the Dental Manual for report requirements). The MassHealth agency does not pay claims for "IC" services without a complete report (see 130 CMR 420.415) . If the documentation is illegible or incomplete, the MassHealth agency denies the claim.
(B) The MassHealth agency determines the appropriate payment for an individual-consideration service in accordance with the following standards and criteria: