Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 433.00
Section 433.03 - 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 eligible 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 publicly assisted client.
(3) Payment Limitations. No purchasing governmental unit may pay less than or more than the approved program rate.
(4) Approved Rates with Applicable Dates of Service Provided on or after July 1, 2021. 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 433.03(4).
Service/Program |
Code |
Unit of Service |
Rate |
Youth Residential Substance Use Disorder Treatment |
H0019-HF |
Per Diem |
$323.55 |
Clinically Intensive Youth Residential Substance Use Disorder Treatment |
H0019-HA |
Per Diem |
$425.39 |
Residential Services |
H0019 |
Per Diem |
$149.20 |
Residential Rehab Pregnant Enhancement |
H0019-TH |
Per Diem |
$41.58 |
Residential Rehab Postpartum Enhancement |
H0019-HD |
Per Diem |
$93.35 |
Residential Rehab Child Enhancement |
H0019-HV |
Per Diem |
$46.67 |
Medically Monitored Inpatient Detoxification |
H0011 |
Per Diem |
$420.77 |
Clinically Managed Inpatient Detoxification |
H0010 |
Per Diem |
$350.93 |
Transitional Support Services |
H0018 |
Per Diem |
$185.21 |
Second Offender Drive Alcohol Education Residential |
H0018-H9 |
Per Diem |
$148.82 |
Jail Diversion - Phase 1 |
H0019-H9 |
Per Diem |
$222.81 |
Jail Diversion - Phase 2 |
H0006-H9 |
Per Hour |
$61.53 |
Family Supportive Housing |
H0019-HR |
Per Diem |
$197.63 |
Family Residential Treatment |
H01019-HR |
Per Diem |
$327.92 |
Supportive Case Management - Permanent Adult |
N/A |
Enrolled Client Day |
$12.43 |
Supportive Case Management - Permanent Families |
N/A |
Enrolled Client Day |
$25.06 |
Supportive Case Management - Permanent Young Adult |
N/A |
Enrolled Client Day |
$34.46 |
Supportive Case Management - Transitional Adult |
N/A |
Enrolled Client Day |
$14.80 |
Supportive Case Management - Transitional Families |
N/A |
Enrolled Client Day |
$29.79 |
Supportive Case Management - Transitional Young Adult |
N/A |
Enrolled Client Day |
$40.17 |
Supportive Case Management - House Manager Add-on |
N/A |
Month |
$2,917.00 |
Supportive Case Management - Outreach and Staffing Supports |
N/A |
Month |
$3,997.00 |
Supportive Case Management - Low Threshold |
N/A |
Enrolled Client Day |
$51.43 |
Supportive Case Management - School Based Targeted Prevention |
N/A |
Month |
$16,882.00 |
Triage, Engagement & Assessment Services - Model A -Base Rate |
N/A |
Monthly Per Slot |
$952.00 |
Triage, Engagement & Assessment Services - Model A -Engagement Staff Rate |
N/A |
Monthly Per Slot |
$534.00 |
Triage, Engagement & Assessment Services - Model A -Engagement Staff Rate Day Program Only |
N/A |
Monthly Per Slot |
$273.00 |
Triage, Engagement & Assessment Services - Model B -Base Rate |
N/A |
Monthly Per Slot |
$1,141.00 |
Triage, Engagement & Assessment Services - Model B -Engagement Staff Rate |
N/A |
Monthly Per Slot |
$720.00 |
Triage, Engagement & Assessment Services - Model B -Engagement Staff Rate Day Program Only |
N/A |
Monthly Per Slot |
$447.00 |
Triage, Engagement & Assessment Services - Peer Service Coordinator Add-on |
N/A |
Per Diem |
$22.04 |
Triage, Engagement & Assessment Services - Social Worker LICSW Add-on |
N/A |
Per Diem |
$38.08 |
Triage, Engagement & Assessment Services - Care Coordinator Add-on |
N/A |
Per Diem |
$22.04 |
Triage, Engagement & Assessment Services - Direct Care Staff Add-on |
N/A |
Per Diem |
$22.04 |
Triage, Engagement & Assessment Services - Support Staff Add-on |
N/A |
Per Diem |
$22.04 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 1 |
N/A |
Monthly |
$2,562.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 2 |
N/A |
Monthly |
$3,611.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 3 |
N/A |
Monthly |
$4,659.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 4 |
N/A |
Monthly |
$5,708.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 5 |
N/A |
Monthly |
$6,757.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 6 |
N/A |
Monthly |
$8,108.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 7 |
N/A |
Monthly |
$9,459.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 8 |
N/A |
Monthly |
$10,810.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 9 |
N/A |
Monthly |
$12,162.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - Tier 10 |
N/A |
Monthly |
$13,513.00 |
Office Based Opioid Treatment (FQHCs) Wraparound Services - 25 Client Add-on |
N/A |
Monthly |
$1,351.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 1 |
N/A |
Monthly |
$4,714.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 2 |
N/A |
Monthly |
$5,763.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 3 |
N/A |
Monthly |
$6,811.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 4 |
N/A |
Monthly |
$7,860.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 5 |
N/A |
Monthly |
$8,908.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 6 |
N/A |
Monthly |
$10,690.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 7 |
N/A |
Monthly |
$12,472.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 8 |
N/A |
Monthly |
$14,253.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 9 |
N/A |
Monthly |
$16,035.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - Tier 10 |
N/A |
Monthly |
$17,817.00 |
Office Based Opioid Treatment - Outpatient Clinic Wraparound Services - 25 Client Add-on |
N/A |
Monthly |
$3,503.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 1 |
N/A |
Monthly |
$4,968.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 2 |
N/A |
Monthly |
$8,495.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 3 |
N/A |
Monthly |
$11,985.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 4 |
N/A |
Monthly |
$15,501.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 5 |
N/A |
Monthly |
$19,018.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 6 |
N/A |
Monthly |
$22,821.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 7 |
N/A |
Monthly |
$26,625.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 8 |
N/A |
Monthly |
$30,428.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 9 |
N/A |
Monthly |
$34,232.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - Tier 10 |
N/A |
Monthly |
$38,035.00 |
Office Based Opioid Treatment - Hospital Wraparound Services - 25 Client Add-on |
N/A |
Monthly |
$2,562.00 |
Office Based Opioid Treatment (FQHCs) Start-up - Level 1 |
N/A |
Monthly |
$8,659.00 |
Office Based Opioid Treatment (FQHCs) Start-up -Level 2 |
N/A |
Monthly |
$12,669.00 |
Service/Program |
Unit of Service |
Rate |
Outreach and Engagement |
Month |
$31,757 |
Safe Haven: ten to 12 beds |
Enrolled day |
$180.45 |
Safe Haven: seven to nine beds |
Enrolled day |
$200.40 |
Dual Diagnosis Shelter - donated space |
Enrolled day |
$163.66 |
Dual Diagnosis Shelter - with occupancy costs |
Enrolled day |
$184.38 |
Housing Options Program: Level 1 |
Enrolled month |
$40.58 |
Housing Options Program: Level 2 |
Enrolled month |
$165.45 |
Assertive Treatment and Relapse Prevention: Model A - nine to 12 clients |
Enrolled day |
$50.98 |
Assertive Treatment and Relapse Prevention: Model B - six to eight clients |
Enrolled day |
$48.57 |
Position Title |
Per Diem |
.25 FTE Monthly |
.50 FTE Monthly |
1.0 FTE Monthly |
Direct Care |
$166 |
$897 |
$1,793 |
$3,587 |
Direct Care III |
$214 |
$1,161 |
$2,321 |
$4,643 |
LICSW |
$302 |
$1,633 |
$3,267 |
$6,534 |
Position |
Hourly Rate |
Direct Care |
$22.04 |
Certified Nursing Assistant |
$22.67 |
Direct Care III |
$28.53 |
Occupational Therapist |
$55.04 |
Occupational Therapist Assistant |
$43.56 |
Case Manager, Social Worker, Clinician (MA level - not Independent Licensed) |
$38.10 |
LPN |
$41.91 |
Registered Nurse |
$63.20 |
Clinician with Independent License |
$44.53 |
Social/Caseworker (BA Level) |
$31.75 |
Nurse Practitioner/APRN |
$86.75 |
Service/Program |
Unit of Service |
Rate |
A |
Monthly |
$11,547 |
B |
Monthly |
$20,111 |
C |
Monthly |
$25,703 |
Service/Program |
Unit of Service |
Rate |
One Family |
Monthly |
$1,090 |
Five Families |
Monthly |
$5,448 |
Service/Program |
Unit of Service |
Rate |
In school |
Curriculum Hour |
$324.70 |
Outside school |
Curriculum Hour |
$405.88 |
Remote Add-on |
Hour |
$81.18 |
Peer Leadership & Youth Development |
Contact Hour |
$243.53 |
Partnership Development |
Hour |
$46.70 |
Service/Program |
Unit of Service |
Rate |
Model 1 |
Month |
$28,418 |
Model 2 |
Month |
$24,586 |
Model 3A |
Month |
$25,547 |
Model 3B |
Month |
$34,615 |
Model 4A |
Month |
$20,030 |
Model 4B |
Month |
$37,806 |
Title |
Unit of Service |
.25 FTE |
.5 FTE |
.75 FTE |
1 FTE |
Clinical (LICSW) |
Monthly |
$1,633 |
$3,268 |
$4,900 |
$6,534 |
Peer/Direct Care |
Monthly |
$897 |
$1,794 |
$2,690 |
$3,587 |
Direct Care III |
Monthly |
$1,160 |
$2,321 |
$3,481 |
$4,641 |
Service/Program |
Unit of Service |
Rate |
Model A |
Month |
$8,435 |
Model B |
Month |
$16,869 |
YPS Specialty Direct Care III Add-on (.5 FTE) |
Month |
$2,321 |
YPS Specialty Direct Care III Add-on (1 FTE) |
Month |
$4,641 |
Service/Program |
Unit of Service |
Rate |
DHILs - Region 1 |
Monthly |
$46,315 |
DHILs - Region 2 |
Monthly |
$40,707 |
DHILs - Region 3 |
Monthly |
$36,502 |
DHILs - Region 4 |
Monthly |
$33,600 |
DHILs - Region 5 |
Monthly |
$21,841 |
DHILs - Region 6 |
Monthly |
$18,927 |
DHILs - Region 7 |
Monthly |
$11,631 |
DHILs - Region 8 |
Monthly |
$7,495 |
Service/Program |
Unit of Service |
Rate |
Recovery Learning Communities |
Monthly |
$76,935 |
Service/Program |
Unit of Service |
Rate |
VRIL Service Add-on |
Per Hour |
$129 |
VRIL Assessment |
Per Component |
$515 |
Independent Living Skills Training |
Per Component |
$1,931 |
Community Resource Access |
Per Component |
$1,931 |
PASS Plan |
Per Component |
$1,931 |
Single Service Purchase |
Per Component |
$901 |
VRIL Group Training Add-on |
Per Client per Class |
$43.49 |
Position |
Unit of Service |
Rate |
Direct Care 0.25 FTE Add-on |
Monthly |
$1,161 |
Direct Care 0.5 FTE Add-on |
Monthly |
$2,321 |
Direct Care 0.75 FTE Add-on |
Monthly |
$3,482 |
Direct Care 1.0 FTE Add-on |
Monthly |
$4,643 |
Service/Program |
Unit of Service |
Rate |
Domestic Violence Community-based Services |
.25 Direct Care FTE |
$1,952 |
Child Exposed to Domestic Violence Services |
.25 Direct Care FTE |
$2,097 |
Supervised Visitation Services |
.25 Direct Care FTE |
$1,990 |
Sexual and Domestic Violence Equity Services |
.25 Direct Care FTE |
$1,952 |
Sexual and Domestic Violence Equity Legal Services |
.25 Direct Care FTE |
$3,028 |
Intimate Partner Abuse Education Services |
Per Cohort |
$2,658 |
Intimate Partner Abuse Education Services - Outreach and Development |
Monthly |
$443 |
Rape Crisis Centers - Dual Agency Tier 1 |
Monthly |
$67,141 |
Rape Crisis Centers - Dual Agency Tier 2 |
Monthly |
$58,974 |
Rape Crisis Centers - Dual Agency Tier 3 |
Monthly |
$50,807 |
Rape Crisis Centers - Dual Agency Tier 4 |
Monthly |
$42,640 |
Rape Crisis Centers - Dual Agency Tier 5 |
Monthly |
$34,473 |
Rape Crisis Centers - Dual Agency Tier 6 |
Monthly |
$26,306 |
Rape Crisis Centers - Dual Agency Tier 7 |
Monthly |
$18,139 |
Rape Crisis Centers - Dual Agency Tier 8 |
Monthly |
$9,972 |
Rape Crisis Centers - Stand-alone Agency Tier 1 |
Monthly |
$70,328 |
Rape Crisis Centers - Stand-alone Agency Tier 2 |
Monthly |
$61,771 |
Rape Crisis Centers - Stand-alone Agency Tier 3 |
Monthly |
$53,214 |
Rape Crisis Centers - Stand-alone Agency Tier 4 |
Monthly |
$44,658 |
Rape Crisis Centers - Stand-alone Agency Tier 5 |
Monthly |
$36,101 |
Rape Crisis Centers - Stand-alone Agency Tier 6 |
Monthly |
$27,544 |
Rape Crisis Centers - Stand-alone Agency Tier 7 |
Monthly |
$18,987 |
Rape Crisis Centers - Stand-alone Agency Tier 8 |
Monthly |
$10,430 |
Rape Crisis Satellite Center Add-on |
Hourly |
$40.40 |
Rape Crisis Direct Care 0.25 FTE Add-on |
Monthly |
$1,952 |
Service/Program |
Unit of Service |
Rate |
Program of Assertive Community Treatment - PACT50 |
Enrollment Day |
$54.02 |
Program of Assertive Community Treatment - PACT80 |
Enrollment Day |
$49.83 |
Program of Assertive Community Treatment - Forensic PACT |
Enrollment Day |
$78.54 |
Program of Assertive Community Treatment - Forensic GLE |
Bed Day |
$323.39 |
Service/Program |
Unit of Service |
Rate |
Respite - A |
Month |
$60,629 |
Respite - B |
Month |
$83,628 |
Respite - C |
Month |
$172,054 |
Respite - Peer Model |
Month |
$43,271 |
Respite - Site Only |
Per Diem |
$262.40 |
Respite - Mobile Only |
Per Diem |
$130.52 |
Service/Program |
Unit of Service |
Rate |
Lead Agency Tier 1 |
Month |
$26,181 |
Lead Agency Tier 2 |
Month |
$31,772 |
Lead Agency Tier 3 |
Month |
$37,060 |
Lead Agency Tier 4 |
Month |
$40,706 |
Lead Agency Tier 5 |
Month |
$55,781 |
Lead Agency Tier 6 |
Month |
$73,749 |
Case Manager/Education Coordinator 0.50 FTE Add-on |
Month |
$2,916 |
Case Manager/Education Coordinator 1.0 FTE Add-on |
Month |
$5,832 |