Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 452.00
Section 452.03 - 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) State Funding Monthly Calculation. The state funding monthly average calculation is calculated according to the following formula: Sum of {[(total fiscal year 2022 State spend on the services listed in 101 CMR 452.01(5) /12 (months)]}.
(5) 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 452.03(5).
|
Add-on |
Unit |
Rate |
|
Workforce Investment for the Services Listed in 101 CMR 452.03(5)(a) |
Monthly |
10% of the Provider's Fiscal Year 2022 Average monthly State Funding |
|
Applicable Program Service(s) |
Parent Regulation |
|
Community Mental Health Center Services |
101 CMR 306.00: Rates of Payment for Mental Health Services Provided in Community Health Centers and Mental Health Centers |
|
Inpatient Services, Residential Services (Excluding Residential Rehab Co-occurring Enhanced), Opioid Treatment Services, Ambulatory Services, Clinical Case Management Services, Day Treatment Services, Outpatient Services, Supportive Case Management Services, Triage, Engagement and Assessment Services, and Office-based Opioid Treatment Programs |
101 CMR 346.00: Rates for Certain Substance-related and Addictive Disorders Programs |
|
Youth Residential Substance Use Disorder Treatment, Clinically Intensive Youth Residential Substance Use Disorder Treatment, Clinically Intensive Residential Treatment, Congregate Care Program Services and Rates and Add-on services, and the services formerly known as "Caring Together" Services |
101 CMR 413.00: Payments for Youth Intermediate-term Stabilization Services |
|
Family and Micro Family Resource Centers and Staff Add-on Services and DMH's Flexible Support Services |
101 CMR 414.00: Rates for Family Stabilization Services |
|
Central Intake and Assessment Program |
101 CMR 417.00: Rates for Certain Elder Care Services |
|
Staffing Support Services and Transitional Age Youth Detoxification and Stabilization Programs |
101 CMR 418.00: Payments for Youth Short-term Stabilization and Emergency Placement Services |
|
Adult Housing and Community Support Services |
101 CMR 421.00: Rates for Adult Housing and Community Support Services |
|
Clinical Team Services |
101 CMR 424.00: Rates for Certain Developmental and Support Services |
|
Alternative Lock-up Program, Conflict of Interest Services, Teen Pregnancy Prevention Services, Therapeutic Day Services and Staff Add-on Services, and Young Parent Support Program and Staff Add-on Services |
101 CMR 427.00: Rates for Certain Youth and Young Adult Support Services |
|
Deaf and Hard of Hearing Independent Living Services, Recovery Learning Communities, and Vocational Rehabilitation Independent Living Services |
101 CMR 428.00: Rates for Certain Independent Living Communities and Services |
|
Domestic Violence Community-based Services, Child Exposed to Domestic Violence Services, Supervised Visitation Services, Sexual and Domestic Equity and Legal Services, Intimate Partner Abuse and Educational Services, Rape Crisis Centers and Satellite Centers, Rape Crisis Direct Care Add-on Staff Services, and Statewide Specialized Hotline Services |
101 CMR 429.00: Rates for Certain Sexual and Domestic Violence Services |
|
Program of Assertive Community Treatment Services |
101 CMR 430.00: Rates for Program of Assertive Community Treatment Services |
|
Respite Services |
101 CMR 431.00: Rates for Certain Respite Services |
|
Lead Agency Services |
101 CMR 432.00: Rates for Certain Lead Agency Services |
|
Psychological Services |
101 CMR 329.00: Psychological Testing, Treatment, and Related Services |
|
Psychiatric Day Treatment |
101 CMR 307.00: Rates for Psychiatric Day Treatment Center Services |
|
Applied Behavior Analysis |
101 CMR 358.00: Rates of Payment for Applied Behavior Analysis |
|
Opioid Treatment Services (excluding codes J0571-J0575 and J3490), Recovery Support Navigator, Individualized Treatment and Stabilization Services |
101 CMR 444.00: Rates for Certain Substance Use Disorder Services |
|
Add-on |
Unit |
Rate |
|
Workforce Investment for the Services Listed in 101 CMR 452.03(5)(b) |
Monthly |
10% of the Provider's Fiscal Year 2022 Average monthly State Funding |
|
Applicable Program Service(s) |
Parent Regulation |
|
Community Mental Health Center Services |
101 CMR 306.00: Rates of Payment for Mental Health Services Provided in Community Health Centers and Mental Health Centers |
|
Inpatient Services, Residential Services (Excluding Residential Rehab Co-occurring Enhanced), Opioid Treatment Services, Ambulatory Services, Clinical Case Management Services, Day Treatment Services, Outpatient Services, Supportive Case Management Services, Triage, Engagement and Assessment Services, and Office-based Opioid Treatment Programs |
101 CMR 346.00: Rates for Certain Substance-related and Addictive Disorders Programs |
|
Youth Residential Substance Use Disorder Treatment, Clinically Intensive Youth Residential Substance Use Disorder Treatment, Clinically Intensive Residential Treatment, Community Treatment Residential, Emergency Residence, Intensive Residential Treatment, Intensive Treatment Residence, Medically Complex and Behavioral Residence, Medically Complex Residence, Specialty Treatment Residence, Young Adult and Youth Therapeutic Group Care, Young Parent Assessment and Living Program, Staff Add-on Services, and the services formerly known as "Caring Together" Services |
101 CMR 413.00: Payments for Youth Intermediate-term Stabilization Services |
|
Family and Micro Family Resource Centers and Staff Add-on Services and DMH's Flexible Support Services |
101 CMR 414.00: Rates for Family Stabilization Services |
|
Central Intake and Assessment Program |
101 CMR 417.00: Rates for Certain Elder Care Services |
|
Adult Housing and Community Support Services |
101 CMR 421.00: Rates for Adult Housing and Community Support Services |
|
Clinical Team Services |
101 CMR 424.00: Rates for Certain Developmental and Support Services |
|
Alternative Lock-up Program, Conflict of Interest Services, Teen Pregnancy Prevention Services, Therapeutic Day Services and Staff Add-on Services, and Young Parent Support Program and Staff Add-on Services |
101 CMR 427.00: Rates for Certain Youth and Young Adult Support Services |
|
Deaf and Hard of Hearing Independent Living Services, Recovery Learning Communities, and Vocational Rehabilitation Independent Living Services |
101 CMR 428.00: Rates for Certain Independent Living Communities and Services |
|
Domestic Violence Community-based Services, Child Exposed to Domestic Violence Services, Supervised Visitation Services, Sexual and Domestic Equity and Legal Services, Intimate Partner Abuse and Educational Services, Rape Crisis Centers and Satellite Centers, Rape Crisis Direct Care Add-on Staff Services, and Statewide Specialized Hotline Services |
101 CMR 429.00: Rates for Certain Sexual and Domestic Violence Services |
|
Program of Assertive Community Treatment Services |
101 CMR 430.00: Rates for Program of Assertive Community Treatment Services |
|
Respite Services |
101 CMR 431.00: Rates for Certain Respite Services |
|
Lead Agency Services |
101 CMR 432.00: Rates for Certain Lead Agency Services |
|
Psychological Services |
101 CMR 329.00: Psychological Testing, Treatment, and Related Services |
|
Psychiatric Day Treatment |
101 CMR 307.00: Rates for Psychiatric Day Treatment Center Services |
|
Opioid Treatment Services (excluding codes J0571-J0575 and J3490), Recovery Support Navigator, Individualized Treatment and Stabilization Services |
101 CMR 444.00: Rates for Certain Substance Use Disorder Services |
|
Add-on |
Unit |
Rate |
|
Workforce Investment for the Services Listed in 101 CMR 452.03(5)(c) |
Monthly |
10% of the Provider's Fiscal Year 2022 Average monthly State Funding |
|
Applicable Program Service(s) |
Parent Regulation |
|
Inpatient Services, Residential Services (Excluding Residential Rehab Co-occurring Enhanced), Supportive Case Management Services, Triage, Engagement and Assessment Services, and Office-based Opioid Treatment Programs |
101 CMR 346.00: Rates for Certain Substance-related and Addictive Disorders Programs |
|
Youth Residential Substance Use Disorder Treatment, Clinically Intensive Youth Residential Substance Use Disorder Treatment, Clinically Intensive Residential Treatment, Community Treatment Residential, Emergency Residence, Intensive Residential Treatment, Intensive Treatment Residence, Medically Complex and Behavioral Residence, Medically Complex Residence, Specialty Treatment Residence, Young Adult and Youth Therapeutic Group Care, Young Parent Assessment and Living Program, Staff Add-on Services, and the services formerly known as "Caring Together" Services |
101 CMR 413.00: Payments for Youth Intermediate-term Stabilization Services |
|
Family and Micro Family Resource Centers and Staff Add-on Services |
101 CMR 414.00: Rates for Family Stabilization Services |
|
Staffing Support Services and Transitional Age Youth Detoxification and Stabilization Programs |
101 CMR 418.00: Payments for Youth Short-term Stabilization and Emergency Placement Services |
|
Adult Housing and Community Support Services |
101 CMR 421.00: Rates for Adult Housing and Community Support Services |
|
Alternative Lock-up Program, Conflict of Interest Services, Teen Pregnancy Prevention Services, Therapeutic Day Services and Staff Add-on Services, and Young Parent Support Program and Staff Add-on Services |
101 CMR 427.00: Rates for Certain Youth and Young Adult Support Services |
|
Deaf and Hard of Hearing Independent Living Services, Recovery Learning Communities, and Vocational Rehabilitation Independent Living Services |
101 CMR 428.00: Rates for Certain Independent Living Communities and Services |
|
Domestic Violence Community-based Services, Child Exposed to Domestic Violence Services, Supervised Visitation Services, Sexual and Domestic Equity and Legal Services, Intimate Partner Abuse and Educational Services, Rape Crisis Centers and Satellite Centers, Rape Crisis Direct Care Add-on Staff Services, and Statewide Specialized Hotline Services |
101 CMR 429.00: Rates for Certain Sexual and Domestic Violence Services |
|
Program of Assertive Community Treatment Services |
101 CMR 430.00: Rates for Program of Assertive Community Treatment Services |
|
Respite Services |
101 CMR 431.00: Rates for Certain Respite Services |
|
Lead Agency Services |
101 CMR 432.00: Rates for Certain Lead Agency Services |
|
Psychiatric Day Treatment |
101 CMR 307.00: Rates for Psychiatric Day Treatment Center Services |
|
Individualized Treatment and Stabilization Services |
101 CMR 444.00: Rates for Certain Substance Use Disorder Services |
