Section 424.404 - Provider EligibilityPayment for services described in 130 CMR 424.000 is made only to providers who are participating in MassHealth on the date the service was provided or who are otherwise eligible for such payment pursuant to 130 CMR 450.000: Administrative and Billing Regulations and who meet the requirements of 130 CMR 424.404(A) and (B).
(A)In-state. A podiatrist practicing in Massachusetts must be licensed by the Massachusetts Board of Registration in Podiatry.(B)Out-of-state. An out-of-state podiatrist must be licensed by that state's board of registration for podiatrists. The MassHealth agency pays an out-of-state podiatrist only when services are provided to an eligible Massachusetts member under the following circumstances:(1) the podiatrist practices outside the Massachusetts border and provides emergency services to a member;(2) the podiatrist practices in a community of Connecticut, Maine, New Hampshire, New York, Rhode Island, or Vermont that is within 50 miles of the Massachusetts border and provides services to a member who resides in a Massachusetts community near the border of that state; or(3) the podiatrist provides services to a member who is authorized to reside out of state by the Massachusetts Department of Social Services.Amended by Mass Register Issue 1319, eff. 8/12/2016.