Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 352.00 - Rates of Payment for Certain Children's Behavioral Health Services
Section 352.03 - Rate Provisions

Universal Citation: 101 MA Code of Regs 101.352

Current through Register 1518, March 29, 2024

(1) Rates as Full Compensation. The rates under 101 CMR 352.03 constitute full compensation for children's behavioral health services provided by community service agencies to publicly aided patients, including full compensation for necessary administration and professional supervision associated with patient care.

(2) Rates of Payment. Payment rates under 101 CMR 352.03 are the lowest of

(a) the eligible provider's usual charge to the general public;

(b) the amount accepted as payment from another payer; or

(c) the schedule of allowable rates for services as set forth in 101 CMR 352.03(3).

(3) Fee Schedule.

(a) Unit of service is per 15 minutes, unless otherwise indicated. Allowable fee for dates of service on or after August 1, 2023.

H0038

$24.69

Self-help/peer services, per 15 minutes (parent-caregiver peer-to-peer support service provided by a family partner)

H2011-HN

$30.57

Crisis intervention service, per 15 minutes (mobile crisis intervention service provided by a paraprofessional, hospital emergency department)

H2011-HO

$39.70

Crisis intervention service, per 15 minutes (mobile crisis intervention service provided by a master-level clinician, hospital emergency department.)

H2014-HN

$20.15

Skills training and development, per 15 minutes (behavior management monitoring provided by a bachelor-level clinician)

H2014-HO

$33.86

Skills training and development, per 15 minutes (behavior management therapy provided by a master-level clinician)

H2019-HN

$22.67

Therapeutic behavioral services, per 15 minutes (therapeutic training and support services provided by a bachelor-level clinician)

H2019-HO

$32.33

Therapeutic behavioral services, each 15 minutes (in-home therapy provided by a master-level clinician)

T1027-EP

$23.24

Family training and counseling for child development, per 15 minutes (therapeutic mentoring service)

H0023-HT

$66.99

Behavioral Health Outreach Service (Targeted Case Management (multi-disciplinary team) that includes family support and training and intensive care coordination per day)

(b) For mobile crisis intervention services at community-based sites of service, refer to 101 CMR 305.00: Rates for Behavioral Health Services Provided in Community Behavioral Health Centers.

(4) Coding Updates and Corrections. EOHHS may publish procedure code updates and corrections in the form of an administrative bulletin. The publication of such updates and corrections will list

(a) codes for which only the code numbers changed, with the corresponding cross-walk;

(b) codes for which the code number remains the same but the description has changed; and

(c) deleted codes for which there is no cross-walk. In addition, for entirely new codes that require new pricing, EOHHS will list these codes and apply individual consideration in reimbursing these new codes until rates are established.

(5) Administrative Bulletins. EOHHS may issue administrative bulletins to clarify its policy on, and understanding of, substantive provisions of 101 CMR 352.00.

(6) Billing. Each eligible provider must bill the governmental unit according to the appropriate fee schedule on a prescribed form. Each specific service must be separately enumerated on the bill.

Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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