Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 431.000 - Independent Diagnostic Testing Facility
Section 431.405 - Maximum Allowable Fees
Universal Citation: 130 MA Code of Regs 130.431
Current through Register 1537, December 20, 2024
(A) The Massachusetts Division of Health Care Finance and Policy (DHCFP) determines the maximum allowable fees for all IDTF services purchased by government agencies. DHCFP publishes a comprehensive listing of IDTF services and rates. Payment is always subject to the conditions, exclusions, and limitations set forth in 130 CMR 431.000. Payment for a service will be the lower of the following:
(1) the provider's usual and
customary fee to the general public for the same or a similar service;
or
(2) the maximum allowable fee
listed in the applicable DHCFP fee schedule.
(B) The maximum allowable payment is full compensation for the IDTF service and any related administrative or supervisory duties in connection with the services, regardless of where the service is provided.
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