Laboratory Services: Specimen Referral

A hospital outpatient department may refer a specimen to an independent laboratory that is eligible to participate in MassHealth, or to another hospital laboratory that is eligible to participate in MassHealth. To be eligible, a hospital laboratory must be in a hospital that is licensed by the Massachusetts Department of Public Health and that is an approved Medicare provider. The referring hospital outpatient department laboratory must inform the prescriber of the name and address of the testing laboratory. The testing laboratory must inform the referring hospital outpatient department laboratory of the results of the test. Only the referring laboratory is authorized to bill the MassHealth agency. (l30 CMR 410.460 Reserved) 4. Program Regulations