Regulation .04 Covered Services.
Regulation .04 Covered Services.LinkCopy Citation
The Program covers the following services:
A.
Medically necessary laboratory services, when the services are:
(1)
Rendered to participants in a physician's office, hospital, freestanding clinic, or medical laboratory;
(2)
Provided according to the laws and regulations of the state and locality in which they are rendered;
(3)
Rendered pursuant to a properly completed order or standing order;
(4)
Adequately documented in the provider’s files;
(5)
Clinical and diagnostic services for which certification by the Centers for Medicare and Medicaid Services (CMS) under CLIA exists, if required; and
(6)
Ordered by an individual who is enrolled as a provider in the Program with an active status on the date of service;
B.
Transportation of specimens by medical laboratories when special handling is required by medical necessity when documentation is supplied to the provider by the authorized ordering practitioner; and
C.
Collection of specimens by venipuncture, capillary puncture, or arterial puncture.