Chapter 87. Free-Standing Independent Diagnostic Testing Facilities

“CMS” means Centers for Medicare and Medicaid Services.

“Department” means Maryland Department of Health.

"Independent Diagnostic Testing Facility (IDTF)” means a fixed location or mobile entity independent of a hospital or physician’s office where diagnostic services are performed by licensed certified non-physician personnel under appropriate physician supervision.

“Major medical equipment” means:

“Mammography” means the radiographic examination of the soft tissues of the breast.

“Medically necessary” means medically necessary as defined in COMAR 10.09.36.01.

“Medicare” means the insurance program administered by the federal government under Title XVIII of the Social Security Act, 42 U.S.C. §1395 et seq.

“NPI” means National Provider Identifier.

“Program" means the Maryland Medical Assistance Program.

Shall possess a valid operator’s license appropriate for the type of vehicle that is driven; and

May not have:

Be approved by Medicare to furnish diagnostic services in an IDTF;

Meets the licensure requirements in accordance with Regulation .02 of this chapter; and

Meets performance standards in accordance with 42 CFR §410.33(g).

The mobile IDTF shall have electronic technology that enables the same day exchange of patient records with the treating physician’s office.

An IDTF mobile unit shall:

The owner or owners of a mobile unit shall submit a business plan to the Department for the mobile unit that includes:

Rendered in a CMS certified IDTF or an IDTF Mobile Unit;

Provided according to the laws and regulations of the state and locality in which they are rendered;

Rendered by a physician or supervised technician;

Ordered in writing by the treating physician or non-physician practitioner, in accordance with State law, who is enrolled as a provider in the Program with an active status on the date of service; and

Adequately documented in the recipient’s medical record.

Diagnostic X-rays;

Computerized Tomography (CT) procedures;

Magnetic Resonance Imaging (MRI);

Magnetic Resonance Angiography (MRA);

Nuclear medicine imaging and radionuclide used in the procedures;

Diagnostic mammography and certain mammography screening;

Ultrasound (US procedures);

Position Emission Tomography (PET);

Radiation oncology; and

Bone mass measurements.

The American College of Radiology;

The Intersocietal Accreditation Commission; or

The Joint Commission on Accreditation of Health Organizations (JCAHO).

Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

Entity, facility, or another provider that is not an individual.

Recording the National Provider Identifier (NPI) number for the individual provider on the claim; or

Recording the name and NPI of the authorized ordering provider on the invoice and attaching to the invoice a copy of the properly completed order that identifies the authorized ordering provider.

The provider’s customary charge unless the service is free to individuals not covered by Medicaid; or

The Department’s fee schedule.

The provider accepts Medicare assignment;

Medicare makes direct payment to the provider;

Medicare has determined that the services are medically necessary;

Initial billing is made directly to Medicare according to Medicare guidelines.

Coinsurance shall be paid at the lesser of:

Completion of forms and reports;

Broken or missed appointments;

Services rendered by mail or telephone; and

Providing a copy of a recipient’s medical record when requested by another licensed provider on behalf of the recipient.