Subsection 144-101-II-101.05 - NON-COVERED SERVICESWhen repeat x-ray examinations of the same body part for the same condition are required because of technical or professional error in the original x-rays, such repeat x-rays are not a covered service and are not reimbursable by the MaineCare Program if performed twice by the same provider.
101.05-1 Mammography Performed in Non-Compliance with the MQSA Mammograms are not covered services when provided in:
(1) a mammography facility which does not possess a Certificate issued by an accrediting body or is out of compliance with State of Maine Radiation Regulations;(2) a mammography facility with a Certificate that has expired; or(3) a mammography facility whose Certificate has been revoked or denied. Mammography facilities may not charge a member for a service denied by the MaineCare Program due to the mammography facility's non-compliance with the Mammography Quality Standards Act (MQSA), Public Law - 102-539.101.05-2 Scope of Portable X-Ray Benefits The scope of portable x-ray procedures that are covered is limited to services that can be safely performed outside an imaging facility, including skeletal films involving arms and legs, pelvis, vertebral column and skull; and chest and abdominal films that do not involve the use of contrast media.
Exclusion from Coverage as Portable X-ray Benefits:
Procedures and examinations that are not covered under the portable x-ray provision include the following:
i. procedures involving fluoroscopy;ii. procedures involving the use of contrast media;iii. procedures requiring the administration of a substance to the patient or injection of a substance into the patient; and/or special manipulation of the patient;iv. procedures that require special medical skill or knowledge possessed by a physician or which require that medical judgment be exercised;v. procedures requiring special technical competency and/or special equipment or materials; orvi. procedures that are not of a diagnostic nature. C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-101, subsec. 144-101-II-101.05