101 CMR, § 444.01 - General Provisions
(1)
Scope and Purpose. 101 CMR 444.00 governs rates of
payment for opioid treatment and other substance use disorder services to be
used by all governmental units making payment to eligible providers of certain
substance use disorder services to publicly assisted clients. The rates for
health care services set forth in 101 CMR 444.00 also apply to individuals
covered by M.G.L. c.152 (the Workers' Compensation Act).
(2)
Applicable Dates of
Service. Rates contained in 101 CMR 444.00 apply for dates of
service provided on or after March 28, 2025.
(3)
Disclaimer of Authorization
of Services. 101 CMR 444.00 is neither authorization for nor
approval of the substantive services for which rates are determined pursuant to
101 CMR 444.00. Governmental units that purchase services from eligible
providers are responsible for the definition, authorization, and approval of
services extended to publicly assisted clients.
(4)
Coding Updates and
Corrections. 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)
deleted codes for which there are no corresponding new codes; and
(c) codes for entirely new services that
require pricing. EOHHS will list these codes and apply individual consideration
(IC) reimbursement for these codes until appropriate rates can be
developed.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(1) Scope and Purpose. 101 CMR 444.00 governs rates of payment for opioid treatment services to be used by all governmental units making payment to eligible providers of certain substance use disorder services to publicly assisted clients. The rates for health care services set forth in 101 CMR 444.00 also apply to individuals covered by M.G.L. c. 152 (the Workers' Compensation Act).
(2) Applicable Dates of Service. Rates contained in 101 CMR 444.00 apply for dates of service provided on or after January 1, 2023.
(3) Disclaimer of Authorization of Services. 101 CMR 444.00 is neither authorization for nor approval of the substantive services for which rates are determined pursuant to 101 CMR 444.00. Governmental units that purchase services from eligible providers are responsible for the definition, authorization, and approval of services extended to publicly assisted clients.
(4) Coding Updates and Corrections. 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) deleted codes for which there are no corresponding new codes; and
(c) codes for entirely new services that require pricing. EOHHS will list these codes and apply individual consideration (I.C.) reimbursement for these codes until appropriate rates can be developed.