Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 425.000 - Psychiatric Inpatient Hospital Services
Section 425.409 - Nonreimbursable Services
Current through Register 1531, September 27, 2024
The following services are not reimbursable:
(A) drugs and durable medical equipment prescribed for take-home use that are readily available from pharmacies or medical providers;
(B) the cost of any treatment or testing of a member or of a specimen from a member who is not an inpatient in the psychiatric inpatient hospital;
(C) room-and-board services on the day of discharge (unless the day of discharge is also the day of admission);
(D) leave-of-absence days;
(E) research or the provision of experimental or unproven procedures;
(F) private hospital rooms, except when medically necessary; and
(G) services furnished by the emergency room or outpatient department on the day of admission, during the inpatient stay, or on the day of discharge.
