If it is not medically necessary for a patient to be personally reassessed prior to prescription renewal,
specialty referral, release of laboratory results, etc., claims for these services must not be made to
MSP regardless of whether or not a medical practitioner chooses to see his/her patients personally or
speak with them via the telephone.
Some services listed in the MSC Payment Schedule have fees which are specifically intended to cover
multiple services over extended time periods. Examples are most surgical procedures, the critical
care per diem listings and some obstetrical listings. The preambles and Schedule are explicit where
these intentions occur.
When, because of serious complications or coincidental non-related illness, additional care is required
beyond that which would normally be recognized as included in the listed service, MSP will give
independent consideration to claims for this additional care, if adequate explanation is submitted with
the claim.
