New Payment Policies (September 2024)

Posted on September 9, 2024

Unlisted Procedures & Services:

• Billing & Documentation Requirements Section
  • Added block for Anesthesia Services
  • Unlisted coded within the range of 00100 – 01999 along with documentation requirements.

Medical Health Policies:

• Non-Emergent Transportation
  • Effective 11/2/2024
  • Medicaid/BeHealthy transportation is directly covered by MassHealth – policy does not apply.
  • For Medicare Advantage, will continue to follow guidance from CMS.
  • Criteria for Commercial LOB in policy.
  • Will continue to cover the following transports with no authorization:
  • Hospital to Hospital
  • Hospital to Acute Rehabilitation or Skilled Nursing Facility
  • Acute Rehabilitation or Skilled Nursing Facility to Hospital

Categories: Provider Newsletter