130 CMR, § 450.124 - Behavioral Health Services
(A)
Behavioral Health Contractor. Except as provided in
130
CMR 450.124(B) and (C), all
behavioral health services covered by the MassHealth agency's contract with the
behavioral health contractor (the Contractor) are authorized, provided, and
paid solely by the Contractor. Payment for such services is subject to the
terms of the Contractor's provider contracts including, but not limited to,
provisions governing service authorization and billing requirements. Any
provider seeking a contract with the Contractor should contact the Contractor
directly.
(B)
Emergency
Services. Members may obtain emergency behavioral health services
from any qualified participating MassHealth provider as well as any provider
that has entered into an agreement with the Contractor. Providers should refer
to MassHealth bulletins for information and guidance on submission of claims
for emergency department behavioral health visits.
(C)
Services to Exempt
Members. Services provided to the following MassHealth members are
not subject to
130
CMR 450.124:
(1) members who are enrolled in an MCO,
Accountable Care Partnership Plan, SCO, or ICO; and
(2) members who are excluded from
participating in managed care under
130
CMR 508.002: MassHealth Members
Excluded from Participation in Managed Care unless such member is
enrolled with the behavioral health contractor pursuant to
130
CMR 508.001(E).
Notes
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