C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-4, subsec. 144-101-II-4.05
Non-covered services are services that are not billable under this section of policy as ASC facility services. ASC facility services do not include physician or anesthetist services (Section 90; Section 14); laboratory (Section 55), radiology or diagnostic procedures (other than those directly related to the performance of the surgical procedure) (Section 101); ambulance services (Section 5); or non-implantable prosthetic devices and durable medical equipment (other than those that serve the function of a case or splint or are otherwise considered integral to the performance of a covered surgical procedure) (Section 60).
Covered procedures are limited to those not expected to result in extensive loss of blood, but in some cases, blood and blood products may be required. When there is a need for blood and blood products, they are considered facility services and no separate charge is permitted.
Other non-covered services include those services that cannot be safely performed in an outpatient setting or without support of a fiall array of hospital diagnostic and treatment services and equipment; and procedures that are not covered by MaineCare (e.g., cosmetic surgery).
Services are not separately billable unless specifically allowed under Medicare.
C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-4, subsec. 144-101-II-4.05