101 CMR 362.03 - Rate Provisions

(1) Rates as Full Compensation. The rates under 101 CMR 362.00 constitute full compensation for community support program services provided by community support programs to publicly aided and industrial accident patients, including full compensation for necessary administration and professional supervision associated with patient care.
(2) Rates of Payment. Payment rates under 101 CMR 362.00 are the lower of
(a) the eligible provider's usual charge to the general public; or
(b) the schedule of allowable rates for services provided by community support programs as set forth in 101 CMR 362.03(4).
(3) Modifiers.
(a) -HK: Specialized mental health programs for high-risk populations (Community Support Program for Homeless Individuals).
(b) -HH: Integrated mental health/substance abuse program (Community Support Program for Justice Involved).
(c) -HE: Mental health program (Community Support Program-Tenancy Preservation Program).
(4) Fee Schedule Rates for Community Support Program Services. The payment rates for community support programs are as follows:

Code

Rate

Service Description

H2015

$15.88

Comprehensive community support services, per 15 minutes (Community Support Program)

H2016-HK

$27.72

Comprehensive community support services, per diem, specialized mental health programs for high-risk populations (Community Support Program for Homeless Individuals)

H2016-HH

$21.44

Comprehensive community support program, per diem, integrated mental health/substance abuse program (Community Support Program for Justice Involved)

H2016-HE

$22.81

Comprehensive community support services, per diem (Community Support Program-tenancy Preservation Program)

Notes

101 CMR 362.03
Adopted by Mass Register Issue 1494, eff. 4/28/2023.

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