Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 429.000 - Mental Health Center Services
Section 429.408 - In-State Providers: Maximum Allowable Fees
Universal Citation: 130 MA Code of Regs 130.429
Current through Register 1531, September 27, 2024
(A) The MassHealth agency pays for mental health center services with rates set by EOHHS, subject to the conditions, exclusions, and limitations set forth in 130 CMR 429.000. EOHHS fees for mental health center services are contained in 101 CMR 306.00: Rates of Payment for Mental Health Services Provided in Community Health and Mental Health Centers.
(1) In the event that the center has a
sliding scale charge structure, the maximum published charges will be
considered the center's usual charge to the general public, provided the
following conditions are met:
(a) the center's
full charges must be published in a fee schedule;
(b) the center's revenues must be based on
the application of full charges with allowances noted for reduction of
fees;
(c) the center's procedure
for reduction of fees must be in accordance with written policies;
and
(d) the center must maintain
sufficient information to document the amount of the reductions.
(2) Centers designated as
Behavioral Health Urgent Care Providers pursuant to
130
CMR 429.404(A) may bill for
the provision of these services according to rates set forth in 101 CMR 306.00:
Rates of Payment for Mental Health Services Provided in Community
Health Centers and Mental Health Centers.
(B) Administrative Operations. Payment by the MassHealth agency for mental health center services includes payment for administrative operations and for all aspects of service delivery not explicitly included in 130 CMR 429.000, such as, but not limited to:
(1) completion of
member registration and intake, which may be completed on a telephonic or
walk-in basis, and shall include accumulating and recording at least the
minimally required member information necessary to facilitate diagnostic
evaluation services, including the members' presenting concern, and for
referral to an appropriate provider or service;
(2) communication with members or other
parties that may include processes for appointment reminders or coordination of
care;
(3) staff supervision or
consultation with another staff member within the mental health
center;
(4) providing information
for the coordination of referrals; and
(5) recordkeeping.
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