5160-11-03.2 Laboratory-related services: provisions specific to portable x-ray services.

 

 

 

5160-11-03.2               Laboratory-related  services:  provisions  specific  to  portable x-ray services.

 

 

 

(A)Procedures having professional and technical components.

 

(1)In general, a portable x-ray supplier must perform the technical component of a procedure.

 

(2)A portable x-ray supplier may receive payment for the technical component alone if it performs only the technical component and the professional component is performed by a qualified practitioner not associated with the portable x-ray supplier by ownership, employment, or contract (e.g., interpretation of an x-ray is performed by an individual's treating practitioner).

 

(3)A portable x-ray supplier may receive payment for a global procedure if it performs both the professional and the technical components. The professional component must be performed by a qualified practitioner who owns, is employed by, or is under contract with the portable x-ray supplier.

 

(4)A  portable  x-ray  supplier  cannot  receive  payment  for  the  professional component alone.

 

(B)Conditions for payment.

 

(1)For payment purposes, only the following radiology procedures are considered to be portable x-ray services: (a) Skeletal films involving the extremities, pelvis, vertebral column, and skull; (b) Chest films; (c) Abdominal films; and (d) Diagnostic mammograms if the provider meets the requirements set forth in 21 C.F.R. part 900 subpart B (April 1, 2014).

 

(2)No payment is made for the following procedures when they are performed by a portable x-ray supplier:

 

(a) Procedures involving fluoroscopy;

 

(b) Procedures involving the use of contrast media;

 

(c) Procedures requiring the administration of a substance to the individual, the injection of a substance into the individual, or special manipulation of the individual;

 

(d)Procedures requiring special medical skill or knowledge possessed by a qualified practitioner or the exercise of medical judgment;

 

(e) Procedures requiring special technical competency or special equipment or materials not ordinarily needed for radiography;

 

 

 

(f)Routine screening procedures; and

(g) Procedures that are not of a diagnostic nature.

(3) Payment is available for the one-way transportation of portable x-ray equipment to a medicaid-eligible individual's place of residence. For each visit, only one equipment transportation charge is allowed, regardless of the number of persons served.

Replaces:                                                              Part of 5160-11-06

Effective:                                                             04/01/2016

Five Year Review (FYR) Dates:                         04/01/2021

CERTIFIED ELECTRONICALLY
Certification
02/29/2016
Date
Promulgated Under:	119.03
Statutory Authority:	5164.02
Rule Amplifies:	5164.02
Prior Effective Dates:	04/07/1977, 09/19/1977, 12/21/1977, 12/30/1977, 10/01/1984 (Emer), 12/30/1984, 06/01/1986, 02/17/1991, 08/01/2001, 05/25/2006