Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 310.00 - Rates for Adult Day Health Services
Section 310.03 - Rate Provisions
Current through Register 1531, September 27, 2024
(1) Rate as Full Payment. Each eligible provider must, as a condition of receipt of payment from one or more purchasing governmental units for services rendered, accept the approved rates as full payment and discharge of all obligations for the services rendered, subject only to appellate rights as set forth in M.G.L. 118E. There will be no duplication or supplementation of payment from sources other than those expressly recognized or anticipated in the computation of the rate. Any client resources or third-party payments received on behalf of a publicly assisted client must reduce, by that amount, the amount of the purchasing governmental unit's obligation for services rendered to the publicly assisted client.
(2) Covered Services. The payment rates in 101 CMR 310.00 apply to adult day health services provided by eligible providers in a day setting, where:
(3) Exclusions. The payment rates in 101 CMR 310.00 do not apply to the following circumstances and services:
(4) Payment Rates. For dates of service on and after July 5, 2023, the base rate for adult day health services is the lower of the established charge or the rate listed below in 101 CMR 310.03(4).
Code |
Per Diem Base Rate |
Description |
S5102 |
$106.32 |
Basic Level of Care |
S5102 TG |
$136.72 |
Complex Level of Care |
Code |
Partial Per Diem Rate |
Description |
S5101 |
$53.16 |
Basic Level of Care |
S5101 TG |
$68.36 |
Complex Level of Care |
Code |
Rate |
Description |
S5105 |
$2000.00 |
Admission Services (one-time only on or after the 45th day of service) |
S5105 KZ |
$2000.00 |
Re-engagement Services (one-time only on or after the 45th day of service) |
T2003 |
$28.56 |
Non-wheelchair (ambulatory) transportation (one-way trip) |
T2003 U6 |
$34.98 |
Wheelchair transportation (one-way trip) |