Fee Schedules

(1) Local veterans’ services departments shall conform to the procedures, methods of payment and statewide fee schedules. Medical services and supplies begin with either the personal physician or clinic and, when recommended, must be approved and paid for in accordance with established fee schedules. Fee schedules for medical services and supplies are part of 114.3 CMR and generally represent rates as established by the Division of Health Care Finance and Policy (DHCFP), formerly the Massachusetts Rate Setting Commission. Established fee schedules for professional services may not be exceeded. A veterans’ agent must refer medical fees and fees for medical services not on fee schedules to the DVS. (Mass. Register #1536, 12/6/2024) 10.02: continued (2) Items of medical care must be recommended in accordance with standards outlined in the Division of Health Care Finance and Policy (DHCFP) regulations at 114.3 CMR. Most items require evaluation and recommendation of the attending physician. In some instances, the professional opinion of a specialist or clinical physician is required; in others, the assessment by a specialized agency such as a hearing evaluation center for a hearing aid or a physical therapist for a wheelchair will be required. A veterans’ agent may approve purchase of recommended items of medical care only when the standards of 114.3 CMR have been satisfied.