101 CMR, § 329.01 - General Provisions

(1) Scope and Purpose. 101 CMR 329.00 governs the rates of payment used by all governmental units in making payments to eligible providers of psychological and licensed independent behavioral health clinician services to publicly aided individuals in any suitable location, such as a private office, the client's place of residence, using telehealth, or other appropriate facility. The rates set forth in 101 CMR 329.00 do not apply to individuals covered by M.G.L. c. 152, Workers' Compensation. Rates for services rendered to such individuals are set forth in 114.3 CMR 40.03(2): Services and Rates Covered by other Regulations.
(2) Applicable Dates of Service. Rates contained in 101 CMR 329.00 apply for dates of service on or after April 25, 2025.
(3) Coverage. 101 CMR 329.00 and the rates of payment contained in 101 CMR 329.00 apply to psychological and licensed independent behavioral health clinician services rendered by eligible providers to publicly aided individuals. As set forth in 101 CMR 329.03(2), the rates of payment under 101 CMR 329.00 are full compensation for all services rendered.
(4) Disclaimer of Authorization of Services. 101 CMR 329.00 is not authorization for or approval of the services for which rates are determined pursuant to 101 CMR 329.00. Purchasing agencies and insurers are responsible for the definition, authorization, and approval of care and services extended to publicly aided clients.
(5) Coding Updates and Corrections. The Executive Office of Health and Human Services (EOHHS) may publish procedure code updates and corrections in the form of an administrative bulletin. The publication of such updates and corrections will list:
(a) codes for which only the code numbers change, with the corresponding cross references between existing and new codes;
(b) codes for which the code remains the same but the description has changed;
(c) deleted codes for which there are no corresponding new codes; and
(d) codes for entirely new services that require pricing. EOHHS will list these codes and apply individual consideration (IC) reimbursement for these new codes until appropriate rates can be developed.
(6) Administrative Bulletins. EOHHS may issue administrative bulletins to clarify its policy on, and understanding of, substantive provisions of 101 CMR 329.00.

Notes

101 CMR, § 329.01
Amended by Mass Register Issue 1485, eff. 1/1/2023. Amended by Mass Register Issue 1546, eff. 4/25/2025.

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