Current through Register 1531, September 27, 2024
(1)
Services and Rates Covered by 114.3 CMR 40.00. Payment rates for the following
health care service are governed by the provisions of 114.3 CMR 40.00. These
services are:
(a) Acupuncture Services -
114.3 CMR 40.05(1)
(b) Anesthesia
Services - 114.3 CMR 40.05(2)
(c)
Chiropractic Services - 114.3 CMR 40.05(3)
(d) Clinical Laboratory Services - 114.3 CMR
40.05(4)
(e) Dental Services -
114.3 CMR 40.05(5)
(f) Durable
Medical Equipment - 114.3 CMR 40.05(6)
(g) Freestanding Diagnostic Facilities -
114.3 CMR 40.05(7)
(h) Freestanding
Ambulatory Surgical Centers - 114.3 CMR 40.05(8)
(i) Homemaker Services - 114.3 CMR
40.05(9)
(j) Medicine - 114.3 CMR
40.05(10)
(k) Psychology Services -
114.3 CMR 40.05(11)
(l) Radiology -
114.3 CMR 40.05(12)
(m) Restorative
Services - 114.3 CMR 40.05(13)
(n)
Surgery - 114.3 CMR 40.05(14)
(2)
Services and Rates Covered by
Other Regulations. Payment rates for the following health care
services are governed by other regulations promulgated by the Division. These
services are:
(a) Abortion and Sterilization
- 114.3 CMR 13.00
(b) Adult Day
Health - 114.3 CMR 10.00
(c)
Ambulance Services - 114.3 CMR 27.00
(d) Chronic Maintenance Dialysis and Home
Dialysis Supplies - 114.3 CMR 37.00
(e) Community Health Center Services - 114.3
CMR 4.00
(f) Hearing Aid Dispensers
- 114.3 CMR 23.00
(g) Home Health
Services, including Private Duty Nursing - 114.3 CMR 50.00
(h) Hospice Services - 114.3 CMR
43.00
(i) Independent Living
Services (Personal Care Attendant) - 114.3 CMR 9.00
(j) Mental Health Services provided in
Community Health Centers and Mental Health Centers - 114.3 CMR 6.00
(k) Nursing Facility Services - 114.2 CMR
6.00; rates for individual facilities posted on Division website
(l) Outpatient Tuberculosis Control Services
- 114.3 CMR 8.00
(m) Prescribed
Drugs - 114.3 CMR 31.00
(n)
Psychiatric Day Treatment - 114.3 CMR 7.00
(o) Resident Care Facilities (Rest Homes)
-114.2 CMR 4.00; rates for individual facilities posted on Division's
website
(p) Substance Abuse
Treatment Services - 114.3 CMR 46.00
(q) Vision Care and Ophthalmic Materials -
114.3 CMR 15.00
(3)
Other Service Providers. If a treatment measure
performed by practitioners of alternative or complementary care, such as
massage therapy, is authorized under 45452 CMR 6.00, the insurer, the
employer and the health care service provider must agree upon the appropriate
method of billing for treatment and the payment rate for such
services.
