101 CMR, § 353.03 - General Payment Provisions

(A) Primary Care Clinicians (PCCs) receive an enhanced rate for certain types of primary and preventive care visits provided to PCC Plan members enrolled with the PCC on the date of service. Ten dollars is added to the fee for the procedure code billed. The MassHealth agency pays PCCs an enhanced fee for delivering primary care services in accordance with the terms of the PCC provider contract.

(B) Primary Care ACO-participating Primary Care Providers (participating PCPs) receive an enhanced rate for certain types of primary and preventive care visits provided to Primary Care ACO members enrolled with the participating PCP on the date of service. Ten dollars is added to the fee for the procedure code for the procedure code billed. The MassHealth agency pays participating PCPs an enhanced fee for delivering primary care services in accordance with the terms of the participating PCP contract.

Notes

101 CMR, § 353.03

Adopted by Mass Register Issue 1361, eff. 3/23/2018. Amended by Mass Register Issue 1443, eff. 5/14/2021.