July 2020 – MassHealth Reminders
Posted on July 2, 2020
For our BeHealthy Partnership members and others utilizing MassHealth with their benefits, Health New England follows the guidance provided by the Executive Office of Health and Human Services (EOHHS). Below are reminders from their recent Bulletins that we are following:
MassHealth’s Bulletin 25: Effective April 1, 2020, a single nasal package consists of two nasal spray inhalers, with each inhaler containing 4 mg of naloxone. To ensure payment to Acute Outpatient Hospitals when your Emergency Department distributes nasal naloxone, you must include the following when submitting the claim:
HCPCS code J3490
Revenue code: 636
Modifier HG
MassHealth’s Bulletin 29: In accordance with the release of the May 2020 Bulletin, the following guidance was provided, which Health New England is following:
15-Minute Code for Applied Behavior Analysis (ABA):
The following code was added to allow for time spent providing parent support in 15-minute units.
Code 97156
Family adaptive behavior treatment guidance, administered by a licensed professional (with or without the patient present), face-to-face with guardian(s)/caregiver(s), every 15 minutes.
Prior Authorization Suspension for Behavioral Health 24-hour Levels of Care:
Health New England with the help of MBHP/Beacon, our Behavioral Health Manager, is following the guidance in regards to the suspension of prior authorization requirements for behavioral health 24-hour levels of care, including inpatient behavioral health services and Intensive Community Based Acute Treatment (ICBAT)/Community Based Acute Treatment (CBAT).
Primary Care Preventive Visits via Telehealth:
MassHealth is allowing, but is not requiring, preventive visits to be delivered via telehealth, when clinically appropriate. MassHealth also recognizes medically necessary components cannot be completed via telehealth and recommends they be completed as soon as possible before or after the state of emergency concludes. Please follow MassHealth billing guidance when submitting a claim.
COVID-19 Remote Patient Monitoring:
MassHealth added a code for COVID-19 remote patient monitoring (COVID-19 RPM) bundled services to facilitate home monitoring of members with confirmed or suspected COVID-19 who do not require Emergency Department or hospital level care but require continued close monitoring.
COVID-19 RPM bundle includes all medically necessary clinical services to monitor seven days of close, in-home, monitoring of members with confirmed or suspected COVID-19. Please follow MassHealth billing guidance when submitting a claim.
