Medical Assistance Program 

Municipally Based Health Services 

Bulletin 3 

August 1995 

 

 

 TO: Municipally Based Health Services Providers Participating in the Medical Assistance 
Program 

 

 FROM: Bruce M. Bullen, Commissioner 

 

 RE: REMITTANCE ADVICE CHANGES 

 

 



Introduction Currently, the remittance advice dollar amounts for paid, adjusted, or 
denied claims reflect the total rate for services delivered to recipients. 
This requires providers to calculate the amount of federal share that 
will be returned to the municipality or regional school. Effective July 
1995, the remittance advice will reflect that calculation for the 
provider. The remittance advice will now show the federal share 
amount available to the provider for services provided through the 
Municipal Medicaid Program. 

 

In order to implement this change, it is necessary for providers to use 
the new federal share amount when billing services through the 
Municipal Medicaid Program. Use the new federal share amount for 
all claims billed after July 31, 1995, regardless of the date that the 
service was delivered. 

 

It is not necessary for providers to correct claims that have already 
been submitted using the old rates. The system will record the 
appropriate amount for each claim. 

 

The following chart depicts the new rates: 

 

PROTOTYPE 

CODE 

DESCRIPTION 

RATE 

 

 

 

 

502.8 

X7668 

.8 Early Intervention 

$53.03/week 

502.6 

X7666 

.6 Residential Placement 
and .5 Cost Share 

$12.08/day 

502.5 

X7665 

.5 Day Placement 

$22.32/day 

502.4 

X7664 

.4 Separate Placement 

$12.19/day 

502.3 

X7663 

.3 Public Day Program 

$ 5.58/day 

502.2 

X7663 

.3 Public Day Program 

$ 5.58/day 

502.1 

X7663 

.3 Public Day Program 

$ 5.58/day 



 

 

Commonwealth of Massachusetts 

Executive Office of Health and Human Services 

Division of Medical Assistance 

600 Washington Street 

Boston, MA 02111