9505.0305 Laboratory And X-Ray Services


Published: 2015

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9505.0305 LABORATORY AND X-RAY SERVICES.


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Subpart 1.

Definition.

"Laboratory and X-ray service" means a professional or technical health related laboratory or radiological service directly related to the diagnosis and treatment of a recipient's health status.


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Subp. 2.

Covered service.

To be eligible for medical assistance payment, an independent laboratory or x-ray service must be ordered by a provider and must be provided in an office or facility other than a clinic, hospital, or hospital outpatient facility as defined in part 9505.0330, subpart 1. Only laboratory services certified by Medicare are eligible for medical assistance payment.


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Subp. 3.

Eligible provider.

To be eligible for participation as a provider of independent laboratory service, a vendor must be certified according to Code of Federal Regulations, title 42, sections 405.1310 to 405.1317. To be eligible for participation as a provider of x-ray service, a vendor must be in compliance with Code of Federal Regulations, title 42, sections 405.1411 to 405.1416.


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Subp. 4.

Payment limitation.

A claim for medical assistance payment of an independent laboratory or x-ray service must be submitted to the department by the provider who performs the service. The payment must be made to the provider who performed the service. The payment must not exceed the amount established by Medicare for the service.