Commonwealth of Massachusetts
MassHealth
Provider Manual Series
Subchapter Number and Title
Table of Contents
Page
vi
Freestanding Ambulatory Surgery Center 
Manual
Transmittal Letter
FAS-26
Date
01/01/13

6.	Service Codes 

	Payable Surgery Services		6-1
	Modifiers		6-12
	Modifiers for Provider Preventable Conditions That Are National Coverage
		Determinations		6-12
       
Appendix A.	Directory .		A-1

Appendix B.	Enrollment Centers		B-1

Appendix C.	Third-Party-Liability Codes .		C-1

Appendix D.	(Reserved)

Appendix E		Admission Guidelines		E-1

Appendix U.	DPH-designated Serious Reportable Events That Are Not Provider
			Preventable Conditions		U-1

Appendix V.	MassHealth Billing Instructions for Provider Preventable Conditions
		V-1

Appendix W.	EPSDT Services Medical and Dental Protocols and Periodicity 
Schedules		W-1

Appendix X.	Family Assistance Copayments and Deductibles		X-1

Appendix Y.	EVS Codes/Messages		Y-1

Appendix Z.	EPSDT/PPHSD Screening Services Codes 		Z-1