Section 436.406 - Individual Consideration(A) Some services listed in Subchapter 6 of the Radiation Oncology Center Manual are designated "I.C.," an abbreviation for individual consideration. Individual consideration means that a fee could not be established for these services. Payment for an individual-consideration service is determined by the MassHealth agency's professional advisers, based on the radiation oncology centers descriptive report of the services furnished, which must be included with the claim.(B) If a service is not listed in Subchapter 6 of the Radiation Oncology Center Manual, a radiation oncology center may submit a claim by using the appropriate "unlisted service" service code. Payment for an unlisted service is determined by individual consideration, based on the center's descriptive report of the service, 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) the policies, procedures, and practices of other third-party insurers both governmental and private;(4) prevailing professional ethics and accepted customs of the diagnostic testing and radiation oncology community; and(5) other standards and criteria as may be adopted by DHCFP or the MassHealth agency.