Section 401.419 - Individual Consideration(A) Some tests listed in Subchapter 6 of the Independent Clinical Laboratory Manual are designated "I.C.," an abbreviation for individual consideration. A fee has not been established for these services. Payment for an individual-consideration service is determined by the MassHealth agency's professional advisers, based on the laboratory's description of the test, which must be included with the claim.(B) If a test is not listed in Subchapter 6 of the Independent Clinical Laboratory Manual, an independent clinical laboratory may submit a claim by using the appropriate "unlisted test" service code. Payment for an unlisted test is determined by individual consideration, based on the laboratory's description of the test, which must be included with the claim.(C) The MassHealth agency considers the following factors when determining the appropriate payment for an individual-consideration service: (1) the amount of time required to perform the service;(2) the degree of skill required to perform the service;(3) policies, procedures, and practices of other third-party payers;(4) prevailing medical-laboratory ethics and accepted custom of the medical-laboratory community; and(5) other standards and criteria as may be adopted by DHCFP.