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Provider Payment Rates

Rates for Community Health Care Providers (Ambulatory Care)
  • Abortion and Sterilization Services Provided by Freestanding Clinics (114.3 CMR 13.00)
  • Acquired Brain Injury Waiver and Related Services (114.3 CMR 54.00)
  • Adult Day Health Services (114.3 CMR 10.00)
  • Adult Foster Care (114.3 CMR 51.00)
  • Ambulance Services (114.3 CMR 27.00)
  • Certain Children's Behavioral Health Services (114.3 CMR 52.00)
  • Certain Placement and Support Services (114.4 CMR 11.00)
  • Chiropractic Services (114.3 CMR 28.00)
  • Chronic Maintenance Dialysis and Home Dialysis Supplies (114.3 CMR 37.00)
  • Clinical Laboratory Services (114.3 CMR 20.00)
  • Community Health Centers (114.3 CMR 4.00)
  • Day Habilitation Program Services (114.3 CMR 48.00)
  • Dental Services (114.3 CMR 14.00)
  • Durable Medical Equipment, Oxygen, Respiratory Therapy Equipment (114.3 CMR 22.00)
  • Early Intervention Program Services (114.3 CMR 49.00)
  • Family Planning Services (114.3 CMR 12.00)
  • Freestanding Ambulatory Surgical Facilities (114.3 CMR 47.00)
  • Hearing Aid Dispensers (114.3 CMR 23.00)
  • Home Health Services (114.3 CMR 50.00)
  • Hospice Services (114.3 CMR 43.00)
  • Independent Living Services for the Personal Care Attendant Program (114.3 CMR 9.00)
  • Medicine (114.3 CMR 17.00)
  • Mental Health Services Provided in Community Health and Mental Health Centers (114.3 CMR 6.00)
  • Outpatient Tuberculosis Control Services (114.3 CMR 8.00)
  • Prescribed Drugs (114.3 CMR 31.00)
  • Primary Care Clinician Plan Services including Pay for Performance Program (114.3 CMR 53.00)
  • Prostheses, Prosthetic Devices, and Orthotic Devices (114.3 CMR 34.00)
  • Psychiatric Day Treatment Center Services (114.3 CMR 7.00)
  • Psychological Services (114.3 CMR 29.00)
  • Radiology (114.3 CMR 18.00)
  • Rehabilitation Clinic Services, Audiological Services; Restorative Services (114.3 CMR 39.00)
  • Substance Abuse Services (114.3 CMR 46.00)
  • Surgery and Anesthesia (114.3 CMR 16.00)
  • TEAM Evaluation Services (114.3 CMR 30.00)
  • Temporary Nursing Services (114.3 CMR 45.00)
  • Vision Care Services and Opthalmic Materials (114.3 CMR 15.00)
  • Workers Compensation Services (other than hospital services) (114.3 CMR 40.00)

Hospitals / Nursing Homes and Rest Homes

  • Hospital Services Provided to Industrial Accident Patients (114.1 CMR 41.00)
  • Intermediate Care Facilities for the Mentally Retarded (114.1 CMR 29.00)
  • Nursing Facilities (114.2 CMR 6.00)
  • Resident Care Facilities (114.2 CMR 4.00)

Purchase of Service: Rates for Social Services
 

  • Competitive Integrated Employment Services (114.4 CMR 10.00)
  • Family Stabilization Services (114.4 CMR 14.00)
  • Family Transitional Support Services (114.4 CMR 12.00)
  • Placement and Support Services (114.4 CMR 11.00)
  • Social, Rehabilitation, and Health Care Services (114.5 CMR 4.00)
  • Youth Intermediate-Term Stabilization Services (114.4 CMR 13.00)

Data Collection and Disclosure

  • Criteria and Procedures for Submission of Health Plan Data (114.5 CMR 11.00)
  • Disclosure of Case Mix and Charge Data (114.5 CMR 2.00)
  • Health Care Claims Data Release (114.5 CMR 22.00)
  • Health Care Payer Claims Data Submission (114.5 CMR 21.00)
  • Health Insurance Responsibility Disclosure (114.5 CMR 18.00)
  • Hospital Financial Reports (114.1 CMR 42.00)
  • Payer Data Reporting (957 CMR 2.00)
  • Payer Reporting of Total Medical Expenses and Relative Prices (114.5 CMR 23.00)
  • Requirement for Submission of Hospital Case Mix and Charge Data (114.1 CMR 17.00)

 

DHCFP Programs

  • Health Safety Net Eligible Services (114.6 CMR 13.00)
  • Health Safety Net Payments and Funding (includes surcharge on hospital payments) 114.6 CMR 14)
  • Student Health Insurance Program (114.6 CMR 3.00)

 

Surcharges and Assessments

  • Employer Fair Share Contribution (114.5 CMR 16.00)
  • Employer Surcharge for State-Funded Health Costs (114.5 CMR 17.00)
  • Health Safety Net Payments and Funding (includes payer surcharge) 114.6 CMR 14.00)
  • Nursing Facility User Fee (114.5 CMR 12.00)
  • Pediatric Immunization Program Assessment (114.5 CMR 20.00)

 



 
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