Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 442.000 - Orthotics Services
Section 442.421 - Claims for Items Priced at Individual Consideration
Universal Citation: 130 MA Code of Regs 130.442
Current through Register 1531, September 27, 2024
The MassHealth agency will not accept a quote attached to a claim for orthotics that are identified in 101 CMR 334.00: Prostheses, Prosthetic Devices and Orthotic Devices; the Orthotics and Prosthetics Payment and Guidelines Tool; or in other guidance issued by MassHealth, as requiring individual consideration (I.C.). For items designated as I.C., the provider must:
(A) attach the actual manufacturer's invoice dated within six months of the prior authorization request to the claim submission;
(B) not accept a printed invoice or order from a manufacturer's web site; and
(C) keep a copy of the quote and the invoice on file.
Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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