With a recent rise in the use of detoxification and/or short-term residential rehabilitation services, also known as clinical stabilization services (CSS), below are Health New England’s coverage details for members. We have also observed an increase in members receiving CSS at out-of-network facilities. Please note, Health New England has a broad network of facilities that offer CSS in both our HMO and PPO networks.

What Health New England covers for Clinical Stabilization Services for Substance Use Disorder

• Health New England covers detoxification and/or short-term residential rehabilitation, also known as CSS, at facilities licensed by the Massachusetts Department of Public Health (DPH) Bureau of Substance Abuse Services for a minimum of fourteen (14) days combined, after which requests for additional coverage are reviewed for medical necessity.
• Applicable member cost share may apply for CSS.

For additional information or questions about covered services and member responsibility, members should contact Health New England Member Services Department at (413) 787-4004 or toll-free at (800) 310-2835.