130 CMR, § 455.402
The following terms used in 130 CMR 455.000 have the meanings given in 130 CMR 455.402, unless the context clearly requires a different meaning. The reimbursability of services defined in 130 CMR 455.000 is not determined by these definitions, but by application of 130 CMR 455.000, and 130 CMR 450.000: Administrative and Billing Regulations.
Primary or Elective Care - medical care required by individuals or families that is appropriate for the maintenance of health and the prevention of illness. Primary or Elective Care includes, but is not limited to, physical examination, diagnosis and management of illness, ongoing health maintenance, accident prevention, and referral when necessary.
Urgent Care - a term defined in 105 CMR 140.000: Licensure of Clinics.
Urgent Care Clinic (UCC) - an entity licensed as a clinic by the Massachusetts Department of Public Health (DPH) pursuant to M.G.L. c. 111, § 51, and 105 CMR 140.000: Licensure of Clinics, if in state, or by the licensing authority of its own state, if out of state, that is not part of a hospital and that possesses its own legal identity, maintains its own patient records, administers its own budget and personnel, and is organized primarily for the purpose of rendering urgent care.
Urgent Care Visit - an in-person encounter between an eligible member and a licensed practitioner (such as a physician or nurse practitioner) or other medical professional under the direction of a licensed practitioner for the provision of urgent care as defined in 130 CMR 455.402.
130 CMR, § 455.402