Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 339.00 - Rates for Restorative Services
Section 339.03 - General Rate Provisions
Current through Register 1531, September 27, 2024
(1) Rate Determination. Rates of payment for authorized services to which 101 CMR 339.00 applies are the lower of
(2) Out-of-office Rates. With the exception of services provided by rehabilitation centers and speech and hearing centers, the fee for any service provided out of the office will be 115% of the respective in-office fee.
(3) Multiple Procedures in Physical Therapy. When more than one type of physical therapy treatment is provided in a single visit, the provider receives 100% of the applicable fee for each procedure, with a maximum of four procedures (or a total of one hour) allowed in a given visit.
(4) Special Contracts. In certain circumstances, purchasing agencies may pay for services on an hourly basis, rather than a per visit basis as described in 101 CMR 339.00. A special contract would be appropriate where a large number of patients are treated by an individual practitioner on a regular basis for a particular purchaser at one site and/or where the treatment times described in the service codes in 101 CMR 339.00 do not define the treatment times authorized by the purchaser.
