Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 462.000 - Licensed Independent Clinical Social Work Services
Section 462.407 - Nonpayable Circumstances

Universal Citation: 130 MA Code of Regs 130.462

Current through Register 1531, September 27, 2024

The MassHealth agency does not pay a licensed independent clinical social worker for services provided under any of the following circumstances.

(A) The licensed independent clinical social worker provided the service in a facility approved by the MassHealth agency and is paid by the facility to provide that service, whether or not the cost of the service is included in the MassHealth agency's rate of payment for that facility.

(B) The licensed independent clinical social worker provided the service in a facility that is organized to provide primarily nonmedical services and is paid by the facility to provide the service.

(C) The licensed independent clinical social worker has received or will receive payment for the service from the Commonwealth, county, or municipality.

(D) Under comparable circumstances, the licensed independent clinical social worker does not customarily bill patients who do not have health insurance.

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