048.0037.26.24
Ch. 26, § 24. Radiology Services
Cite as Medicaid Rules, Ch. 26, § 24
(a) Eligible providers. Licensed independent radiology practices, hospitals, and physician practices.
(b) Excluded services:
(i) Unordered radiological studies; and
(ii) Separate consultations procedures unless ordered by the attending
physician, nurse practitioner or physician's assistant.
(c) Limited services:
(i) Routine mammography is limited as follows:
(A) One mammography between the ages of thirty-five (35) and thirty-
nine (39); and
(B) One mammography per year at age forty (40) and after.
(ii) Services performed in a physician's office shall be covered only if performed by or under the direct supervision of the physician.
(iii) Services performed in a hospital using equipment owned by the provider. The provider may bill for the total procedure if the technical component is not billed by the hospital.