Rule 5160-11-21. Portable x-ray supplier services

119.03 (A) Providers. An entity may enroll in medicaid as a portable x-ray supplier only if it complies with the conditions set forth in 42 C.F.R. part 486 subpart C (October 1, 2025). (B) Coverage. (1) The radiology procedures performed by a portable x-ray supplier have both a professional component and a technical component. (a) In general, a portable x-ray supplier performs the technical component of a procedure. (b) 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 physician or other qualified healthcare professional 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). (c) A portable x-ray supplier may receive payment for a global procedure if it performs both the professional and the technical components and the professional component is performed by a physician or other qualified healthcare professional who owns, is employed by, or is under contract with the portable x-ray supplier. (d) A portable x-ray supplier cannot receive payment for the professional component alone. (2) For payment purposes, only the following radiology procedures are considered to be portable x-ray services: (a) Skeletal imaging involving the extremities, pelvis, vertebral column, and skull; (b) Chest imaging; (c) Abdominal imaging; and (d) Diagnostic mammography if the provider meets the conditions set forth in 21 C.F.R. part 900 subpart B (October 1, 2025). (3) Provisions affecting payment for radiology services are set forth in rule 5160-4-25 of the Administrative Code. (4) 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 a contrast medium; (c) Procedures involving the administration of a substance to the individual, the injection of a substance into the individual, or special manipulation of the individual; (d) Procedures involving special medical skill or knowledge possessed by a physician or other qualified healthcare professional or the exercise of medical judgment; (e) Procedures involving 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. (5) 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. (C) Claim payment. For a covered global radiology procedure and its professional and technical components and for covered transportation of portable x-ray equipment, the medicaid maximum payment amounts are indicated in appendix DD to rule 5160-1-60 of the Administrative Code. Last updated March 9, 2026 at 11:02 AM Supplemental Information Authorized By: 5164.02 Amplifies: 5164.02 3/9/2031 12/29/1983, 10/1/1984 (Emer.), 12/30/1984, 5/9/1986, 9/1/1989, 12/29/1995 (Emer.), 8/1/2001, 4/1/2004, 12/31/2007 (Emer.)