Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 449.00 - Rates for Certain Home- and Community-based Services Related to Workforce Development
Section 449.03 - 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 a provider, as explicitly set forth in the terms of the purchase agreement between the 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, 2022. 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 449.03(4).
|
Code |
Unit |
Rate |
Per Unit Rate Add-on |
Total |
|
G0156 |
Per 15 minutes |
$7.40 |
$0.89 |
$8.29 |
|
G0156 UD |
Per 15 minutes |
$7.40 |
$0.89 |
$8.29 |
|
99509 |
Per 15 minutes |
$7.40 |
$0.89 |
$8.29 |
|
Code |
Service |
Unit |
Rate |
Per Unit Rate Add-on |
Total |
|
S5130 U4, S5130 U8 U1 |
Homemaker (Agency Rate) |
Per 15 minutes |
$6.93 |
$0.99 |
$7.92 |
|
S5130 U8 U2, S5130 U8 UB |
Homemaker (Non-agency Rate for Individual Providers and Self-directed Services) |
Per 15 minutes |
$6.22 |
$0.99 |
$7.21 |
|
G0156 U8 |
Home Health Aide (Agency Rate) |
Per 15 minutes |
See 101 CMR 449.03(4)(a). |
||
|
T1019 U4, T1019 U8 U1 |
Personal Care (Agency Rate) |
Per 15 minutes |
$6.99 |
$0.99 |
$7.98 |
|
Service |
Unit |
Self-directed Worker Rate |
Employer Expense Component |
Self-directed Service Rate |
|
Homemaker |
Per 15 minutes |
$6.40 |
$0.81 |
$7.21 |
(5) Approved Rates with Applicable Dates of Service Provided on or after July 1, 2023.
|
Code |
Unit |
Rate |
Per Unit Rate Add-on |
Total |
|
G0156 |
Per 15 minutes |
$6.73 |
$0.89 |
$7.62 |
|
G0156 UD |
Per 15 minutes |
$6.73 |
$0.89 |
$7.62 |
|
Code |
Service |
Unit |
Rate |
Per Unit Rate Add-on |
Total |
|
S5130 U4, S5130 U8 U1 |
Homemaker (Agency Rate) |
Per 15 minutes |
$6.30 |
$0.99 |
$7.29 |
|
S5130 U8 U2, S5130 U8 UB |
Homemaker (Non-agency Rate for Individual Providers and Self-directed Services) |
Per 15 minutes |
$5.65 |
$0.99 |
$6.64 |
|
G0156U8 |
Home Health Aide (Agency Rate) |
Per 15 minutes |
See101 CMR 449.03(5)(a). |
||
|
T1019 U4, T1019 U8 U1 |
Personal Care (Agency Rate) |
Per 15 minutes |
$6.35 |
$0.99 |
$7.34 |
|
Service |
Unit |
Self-directed Worker Rate |
Employer Expense Component |
Self-directed Service Rate |
|
Homemaker |
Per 15 minutes |
$5.90 |
$0.74 |
$6.64 |
(6) Approved Rates with Applicable Dates of Service Provided on or after July 1, 2022
