C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-15, subsec. 144-101-II-15.04

Current through 2024-51, December 18, 2024

Subsection 144-101-II-15.04 - COVERED SERVICES

If CMS approves, the Department shall make payment for covered services that are specifically included in the Department's MBM, Chapter III, Section 15, "Allowances for Chiropractic Services". Covered services are limited to the following:

A. Evaluation or re-evaluation of spinal conditions to determine the rehabilitative effectiveness of chiropractic manipulation prescribed pursuant to Section 15.03(B).

B. Manual or mechanical manipulation of the spine that is medically necessary to treat spinal conditions.

C. X-ray services that are medically necessary for diagnosis and treatment of spinal conditions.

Medical necessity must be supported and documented in accordance with criteria defined in Section 15.07-3, "Member Records". The Department reserves the right to request additional information to evaluate medical necessity.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-15, subsec. 144-101-II-15.04