Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 414.00 - Rates For Family Stabilization Services
Section 414.03 - Rate Provisions
Current through Register 1531, September 27, 2024
(1) Services Included in the Rate. The approved rate includes payment for all care and services that are part of the program of services of an eligible provider, as explicitly set forth in the terms of the purchase agreement between the eligible provider and the purchasing governmental unit(s).
(2) Reimbursement as Full Payment. Each provider must, as a condition of acceptance of payment made by any purchasing governmental units for services rendered, accept the approved program rate as full payment and discharge of all obligations for the services rendered. Payment from any other source will be used to offset the amount of the purchasing governmental unit's obligation for services rendered to the participant.
(3) Payment Limitations. No purchasing governmental unit may pay less than or more than the approved program rate.
(4) Services Provided in Dukes or Nantucket County. In accordance with the provisions of St. 2016, c. 133, payment for services provided in programs located in Dukes or Nantucket County is the rate for the service contained in 101 CMR 414.03(6) times a factor of 1.07.
(5) Administrative Adjustment for Extraordinary Circumstances. A method whereby, subject to availability of funds, a purchasing governmental unit may provide additional resource allocations to a qualified provider in response to unusual and unforeseen circumstances that substantially increase the cost of service delivery in ways not contemplated in the development of current rates. It must be demonstrated that such cost increases gravely threaten the stability of service provision such that client or consumer access to necessary services is at risk. The purchasing governmental unit will evaluate the need for the administrative adjustment, determine whether funding is available, and convey that information to EOHHS for review to determine the amount of any adjustment.
(6) Approved Rates. The approved rate is the lower of the provider's charge or amount accepted as payment from another payer or the rate listed in 101 CMR 414.03(6).
|
Service |
Center Size |
Unit of Service |
Agency Rate |
|
Adolescent Support Network |
Enrolled day |
$26.75 |
|
|
Adult Companion |
15 minutes |
$9.75 |
|
|
Adult Companion Group Services Group of 2 |
15 minutes |
$4.88 |
|
|
Adult Companion Group Services Group of 3 |
15 minutes |
$3.25 |
|
|
After-school Respite |
Half day |
$64.30 |
|
|
After-school Respite |
Full day |
$110.58 |
|
|
Autism Support Center/Family Support Center |
0.5 |
Month |
$5,827.56 |
|
Autism Support Center/Family Support Center |
1 |
Month |
$11,655.12 |
|
Autism Support Center/Family Support Center |
1.5 |
Month |
$17,482.68 |
|
Autism Support Center/Family Support Center |
2 |
Month |
$23,310.25 |
|
Autism Support Center/Family Support Center |
2.5 |
Month |
$27,676.70 |
|
Autism Support Center/Family Support Center |
3 |
Month |
$32,540.52 |
|
Autism Support Center/Family Support Center |
3.5 |
Month |
$37,348.43 |
|
Autism Support Center/Family Support Center |
4 |
Month |
$42,098.18 |
|
Autism Support Center/Family Support Center |
4.5 |
Month |
$46,797.24 |
|
Autism Support Center/Family Support Center |
5 |
Month |
$51,462.55 |
|
Autism Support Center/Family Support Center |
5.5 |
Month |
$56,101.18 |
|
Autism Support Center/Family Support Center |
6 |
Month |
$60,854.56 |
|
Autism Support Center/Family Support Center |
6.5 |
Month |
$65,610.75 |
|
Autism Support Center/Family Support Center |
7 |
Month |
$70,322.03 |
|
Autism Support Center/Family Support Center |
7.5 |
Month |
$75,044.46 |
|
Autism Support Center/Family Support Center |
8 |
Month |
$79,686.55 |
|
Autism Support Center/Family Support Center |
8.5 |
Month |
$84,218.28 |
|
Autism Support Center/Family Support Center |
9 |
Month |
$88,710.24 |
|
Autism Support Center/Family Support Center |
9.5 |
Month |
$93,202.21 |
|
Autism Support Center/Family Support Center |
10 |
Month |
$97,659.00 |
|
Autism Support Center/Family Support Center |
10.5 |
Month |
$102,123.03 |
|
Autism Support Center/Family Support Center |
11 |
Month |
$106,569.56 |
|
Autism Support Center/Family Support Center |
11.5 |
Month |
$111,034.12 |
|
Autism Support Center/Family Support Center |
12 |
Month |
$115,507.30 |
|
Agency with Choice |
N/A |
I.C. |
|
|
Agency with Choice Admin Fee |
Month |
$375.74 |
|
|
Behavioral Support Services Bachelor's |
15 minutes |
$20.92 |
|
|
Behavioral Support Services Master's |
15 minutes |
$33.14 |
|
|
Behavioral Support Services PhD |
15 minutes |
$41.95 |
|
|
Client Financial Assistance/Flex Funding |
N/A |
I.C. |
|
|
Client Financial Assistance/Flex Funding Administration |
Transaction |
$18.65 |
|
|
Community-based After-school Social and Recreation Programs |
Group Hour |
$42.38 |
|
|
Combined Hourly Services: |
|||
|
Nonclinical |
Hour |
$68.84 |
|
|
Clinical |
Hour |
$103.65 |
|
|
Comprehensive Services: |
|||
|
Model A-1 Direct Care - Nonclinical, Less Intensive |
Enrolled day |
$47.98 |
|
|
Model A-2 Direct Care - Nonclinical, More Intensive |
Enrolled day |
$72.54 |
|
|
Model B Direct Care and Clinical, Less Intensive |
Enrolled day |
$91.20 |
|
|
Model C Direct Care and Clinical, More Intensive |
Enrolled day |
$92.52 |
|
|
Model D Clinical |
Enrolled day |
$91.29 |
|
|
Model E Direct Care and Clinical High Intensive |
Enrolled day |
$132.37 |
|
|
Model F Direct Care and Clinical Highest Intensive |
Enrolled day |
$220.98 |
|
|
Model G Direct Care and Clinical Higher Intensive |
Enrolled day |
$163.54 |
|
|
Educational Coordination |
Enrolled day |
$22.66 |
|
|
Family Navigation |
15 minutes |
$18.70 |
|
|
Family Resource Center |
Month |
$61,097 |
|
|
Micro Family Resource Center |
Month |
$24,785 |
|
|
Micro Family Resource Center Add-on |
Month |
$7,105 |
|
|
Family Resource Center Per Diem Add-on: Family Support Worker |
Per Diem |
$266.24 |
|
|
Family Resource Center Per Diem Add-on: Clinician (LCSW) |
Per Diem |
$372.56 |
|
|
Family Resource Center Per Diem Add-on: Clinician (LICSW) |
Per Diem |
$428.56 |
|
|
Family Resource Center Per Diem Add-on: Family Partner |
Per Diem |
$208.67 |
|
|
Family Resource Center Per Diem Add-on: School Liaison |
Per Diem |
$296.93 |
|
|
Family Training Groups: |
|||
|
Specialty Family Skills Development Program Model |
Session |
$2,952.38 |
|
|
Add-ons for a Specialty Family Skills Development Program Model: |
|||
|
Occupancy Purchase of Space |
Session |
$140.77 |
|
|
Family Skills Development Program Model |
Session |
$2,059.32 |
|
|
Add-ons for a Specialty Family Skills Development Program Model: |
|||
|
Occupancy Purchase of Space |
Session |
$140.77 |
|
|
Family Skills Development Program Model |
Session |
$2,059.32 |
|
|
Add-ons for a Family Skills Deve |
opment Program Model: |
||
|
Facilitator/Coordinator |
Session |
$70.58 |
|
|
Meals |
Session |
$173.10 |
|
|
Child Care |
Session |
$49.91 |
|
|
Occupancy Purchase of Space |
Session |
$140.77 |
|
|
Transportation |
Session |
$168.94 |
|
|
Parent Skill Development Program Model |
Session |
$1,532.93 |
|
|
Add-ons for a Parent Skill Development Program Model: |
|||
|
Facilitator/Coordinator |
Session |
$70.58 |
|
|
Meals |
Session |
$173.10 |
|
|
Child Care |
Session |
$49.91 |
|
|
Occupancy Purchase of Space |
Session |
$140.77 |
|
|
Transportation |
Session |
$168.94 |
|
|
Family Training |
15 minutes |
$13.25 |
|
|
Family Training Group of 2 |
15 minutes |
$6.63 |
|
|
Family Training Group of 5 |
15 minutes |
$2.65 |
|
|
Intensive Flexible Family Support Services |
Enrolled day |
$25.39 |
|
|
Medically Complex Programs |
Month |
$415.30 |
|
|
Peer Support |
15 minutes |
$9.75 |
|
|
Peer Support Group of 2 |
15 minutes |
$4.88 |
|
|
Peer Support Group of 5 |
15 minutes |
$1.95 |
|
|
Planned Site-based Respite for Children |
Day |
$437.82 |
|
|
Planned Site-based Respite for Children, High-intensity Support Needs |
Day |
$569.44 |
|
|
Planned Site-based Respite for Children |
30 minutes |
$27.37 |
|
|
Planned Site-based Respite for Children, High-intensity Support Needs |
30 minutes |
$35.59 |
|
|
Respite in Caregiver's Home, Level 1 |
Day |
$145.19 |
|
|
Respite in Caregiver's Home, Level 2 |
Day |
$176.03 |
|
|
Respite in Caregiver's Home, Level 3 |
Day |
$206.86 |
|
|
Respite in Recipient's Home, 1:1 |
15 minutes |
$9.75 |
|
|
Respite in Recipient's Home, 1:2 |
15 minutes |
$4.88 |
|
|
Respite in Recipient's Home, 1:3 |
15 minutes |
$3.25 |
|
|
Respite in Recipient's Home |
Day |
$351.00 |
|
|
Site-based Respite |
Day |
$302.19 |
|
|
Site-based Respite with Nursing |
Day |
$380.96 |
|
|
Unbundled Intensive Foster Care Special Support |
Child day |
$63.32 |
|
|
Family Navigation Administrative Service |
Transaction |
$40.87 |
|
|
Flexible Supports Service |
Level |
Hourly Rate |
Monthly Rate 1.0 FTE |
Monthly Rate 0.75 FTE |
Monthly Rate 0.5 FTE |
Monthly Rate 0.25 FTE |
|
Program Manager |
1 |
N/A |
$9,329 |
$6,997 |
$4,664 |
$2,332 |
|
Program Manager |
2 |
N/A |
$9,420 |
$7,065 |
$4,710 |
$2,355 |
|
Clinician |
1 |
$94.66 |
$8,086 |
$6,064 |
$4,043 |
$2,021 |
|
Clinician |
2 |
$111.30 |
$9,507 |
$7,130 |
$4,754 |
$2,377 |
|
Family Partner |
1 |
$74.20 |
$5,880 |
$4,410 |
$2,940 |
$1,470 |
|
Family Partner |
2 |
$88.72 |
$7,031 |
$5,273 |
$3,516 |
$1,758 |
|
Peer Mentor/Therapeutic Support Specialist |
1 |
$70.90 |
$5,702 |
$4,276 |
$2,851 |
$1,425 |
|
Peer Mentor/Therapeutic Support Specialist |
2 |
$85.22 |
$6,853 |
$5,140 |
$3,426 |
$1,713 |
