(1)
Scope.
101 CMR
359.00 governs the payment rates, effective as
provided under
101
CMR 359.03 for services in four Home and
Community-based Services (HCBS) Waivers purchased by a governmental unit. The
four HCBS Waivers are: Acquired Brain Injury Non-residential Habilitation
(ABI-N) Waiver, Acquired Brain Injury Residential Habilitation (ABI-RH) Waiver,
Moving Forward Plan Community Living (MFP-CL) Waiver, and Moving Forward Plan
Residential Supports (MFP-RS) Waiver. Listed in
101
CMR 359.01(1)(a) through (d)
are the waiver services available in each waiver.
(a) ABI-N Waiver Services:
1. Adult Companion
2. Assistive Technology
3. Chore Services
4. Community-based Day Supports
5. Community Family Training
6. Community Support &
Navigation
7. Day
Services
8. Home Accessibility
Adaptations
9. Home Delivered
Meals
10. Home Health
Aide
11. Homemaker
12. Independent Living Supports
13. Individual Support and Community
Habilitation
14. Laundry
15. Occupational Therapy
16. Orientation and Mobility
Services
17. Peer Support
18. Personal Care
19. Physical Therapy
20. Prevocational Services
21. Respite Services
22. Shared Home Supports
23. Skilled Nursing
24. Specialized Medical Equipment
25. Speech Therapy
26. Supported Employment
27. Supportive Home Care Aide
28. Transitional Assistance
29. Vehicle Modification
30. Transportation
(b)
ABI-RH Waiver
Services:
1. Assisted Living
Services
2. Assistive
Technology
3. Community-based Day
Supports
4. Community Support &
Navigation
5. Day
Services
6. Home Accessibility
Adaptations (available only in Shared Living - 24-hour Supports)
7. Individual Support and Community
Habilitation
8. Occupational
Therapy
9. Orientation and Mobility
Services
10. Peer Support
11. Physical Therapy
12. Prevocational Services
13. Residential Family Training
14. Residential Habilitation
15. Shared Living - 24-Hour
Supports
16. Skilled
Nursing
17. Specialized Medical
Equipment
18. Speech
Therapy
19. Supported
Employment
20. Transitional
Assistance
21.
Transportation
(c)
MFP-CL Waiver Services:
1. Adult Companion
2. Assistive Technology
3. Chore Services
4. Community-based Day Supports
5. Community Family Training
6. Community Support and Navigation
7. Day Services
8. Home Accessibility Adaptations
9. Home Delivered Meals
10. Home Health Aide
11. Homemaker
12. Independent Living Supports
13. Individual Support and Community
Habilitation
14. Laundry
15. Occupational Therapy
16. Orientation and Mobility
Services
17. Peer Support
18. Personal Care
19. Physical Therapy
20. Prevocational Services
21. Respite Services
22. Shared Home Supports
23. Skilled Nursing
24. Specialized Medical Equipment
25. Speech Therapy
26. Supported Employment
27. Supportive Home Care Aide
28. Transportation
29. Transitional Assistance
30. Vehicle Modification
(d) MFP-RS Waiver Services:
1. Assisted Living Services
2. Assistive Technology
3. Community-based Day Supports
4. Community Support and Navigation
5. Day Services
6. Home Accessibility Adaptations (available
only in Shared Living - 24-hour Supports)
7. Individual Support and Community
Habilitation
8. Occupational
Therapy
9. Orientation and Mobility
Services
10. Peer Support
11. Physical Therapy
12. Prevocational Services
13. Residential Family Training
14. Residential Habilitation
15. Shared Living - 24-hour
Supports
16. Skilled
Nursing
17. Specialized Medical
Equipment
18. Speech
Therapy
19. Supported
Employment
20. Transitional
Assistance
21.
Transportation
(2)
Applicable Dates of
Service. Rates contained in
101 CMR
359.00 apply for dates of service on or after July 1,
2023.
(3)
Disclaimer of
Authorization of Services.
101 CMR
359.00 is neither authorization for nor approval of
the services for which rates are determined pursuant to
101 CMR
359.00. Governmental units that purchase MFP Waiver
Services and/or ABI Waiver Services are responsible for the definition,
authorization, and approval of services extended to participants.
(4)
Administrative
Bulletins. EOHHS may issue administrative bulletins to clarify its
policy on substantive provisions of
101 CMR
359.00.
(5)
Coding Updates and
Corrections. EOHHS may publish service code updates and
corrections by administrative bulletin. Updates may reference coding systems
including, but not limited to, the American Medical Association's Current
Procedural Terminology (CPT) and Healthcare Common Procedure Coding System
(HCPCS) maintained by the Centers for Medicare and Medicaid Services (CMS). The
publication of such updates and corrections will list
(a) codes for which only the code numbers
change, with the corresponding cross references between existing and new
codes;
(b) deleted codes for which
there are no corresponding new codes; and
(c) codes for entirely new services that
require pricing. These codes will be paid on an individual consideration basis
until rates are established.
