Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 405.000 - Community Health Center Services
Section 405.426 - Obstetric Services: Fee-for-service Method of Payment
Current through Register 1531, September 27, 2024
The fee-for-service method of payment is always available to a provider for obstetric services covered by MassHealth. If the global fee requirements in 130 CMR 405.423 are not met, the provider or providers may claim payment from the MassHealth agency only on a fee-for-service basis as specified in 130 CMR 405.426(A) and (B).
(A) If the pregnancy is terminated by an event other than a delivery, each provider involved in performing obstetric services for the member may claim payment only on a fee-for-service basis.
(B) When additional services (for example, ultrasound or special tests) are performed, the provider may claim payment for these only on a fee-for-service basis.
