Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 429.000 - Mental Health Center Services
Section 429.410 - Nonreimbursable Services

Universal Citation: 130 MA Code of Regs 130.429

Current through Register 1531, September 27, 2024

(A) Nonmedical Services. The MassHealth agency does not pay mental health centers for nonmedical services. These services include, but are not limited to, the following:

(1) vocational rehabilitation services;

(2) sheltered workshops (a program of vocational counseling and training in which participants receive paid work experience or other supervised employment);

(3) educational services;

(4) recreational services (play therapy, the use of play activities with a child in an identified treatment setting as an alternative to strictly verbal expression of conflicts and feelings, is not considered a recreational service and is reimbursable);

(5) life enrichment services (ego enhancing services such as workshops or educational courses provided to functioning persons); and

(6) other services such as providing information, referral, and advocacy to certain age populations, liaising with other agencies, role modeling, and community organization.

(B) Travel Time for Outreach. Travel time to and from an outreach visit, including a member's home, place of residence, or an appropriate, mutually-agreed-upon community-based location is not a reimbursable service.

(C) Nonmedical Programs. The MassHealth agency does not pay for diagnostic and treatment services that are provided as an integral part of a planned and comprehensive program that is organized to provide primarily nonmedical or other nonreimbursable services. Such programs include residential programs, day activity programs, drop-in centers, and educational programs.

(D) Research and Experimental Treatment. The MassHealth agency does not pay for research or experimental treatment.

(E) Referrals. A provider to whom a member is referred must bill the MassHealth agency directly for any services rendered as a result of the referral, not through the mental health center.

(F) In order to receive payment for referral services, the rendering provider must be a participating provider in MassHealth on the date of service. (See 130 CMR 429.421(6)).

Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.