Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 353.00 - Payment for Primary Care Clinician Plan Services and Primary Care ACO Participating Primary Care Provider Services
Section 353.01 - General Provisions
Current through Register 1518, March 29, 2024
(1) Scope and Purpose. 101 CMR 353.00 governs certain payments to Primary Care Clinicians (PCCs) for Primary Care Clinician (PCC) services provided to MassHealth members as part of the MassHealth PCC Plan, and to Primary Care ACO-participating Primary Care Providers (participating PCPs) for participating PCP services provided to members enrolled in MassHealth Primary Care ACOs. The enhancement rate payments described in 101 CMR 353.00 are in addition to payments issued under the Acute Hospital Request for Applications, and 101 CMR 304.00: Rates for Community Health Centers; 101 CMR 316.00: Surgery and Anesthesia Services; 101 CMR 317.00: Medicine; and 101 CMR 318.00: Radiology.
(2) Disclaimer of Authorization of Services. 101 CMR 353.00 is not authorization for or approval of the procedures for which payments are determined pursuant to 101 CMR 353.00. Purchasing agencies and insurers are responsible for the definition, authorization, and approval of care and services extended to publicly aided individuals.
(3) Administrative Bulletins. EOHHS may issue administrative bulletins to clarify its policy on and understanding of substantive provisions of 101 CMR 353.00.
