Family and Children's Medicaid MA-3540 Medicaid Covered Services
XXVi. RADIOLOGICAL (X-RAY) SERVICES
Refer to DMA’s website at http://www.dhhs.state.nc.us/dma/mp/mpindex.htm for specific coverage criteria, prior approval requirements, and service limitations.
A. Covered Services
a. Screening mammograms are reimbursed on an annual basis for all recipients age 40 and older.
b. One screening mammogram will be reimbursed from age 35 through 39.
2. Magnetic Resonance Imaging (MRI) scans.
3. Positron Emission Tomography (PET) scans.
1. Must be ordered by a licensed practitioner.
2. Counts toward a recipient’s professional visits visit limit, EXCEPT as noted in II.A. and:
a. Radiation therapy for malignancy, or
b. If performed as the result of a referral and the service is given and billed on the same date of referral.
There are no copayments for radiological (x-ray) services.
REVISED 08/01/11 – CHANGE NO. 14-11