Commonwealth of Massachusetts 
MassHealth 
Provider Manual Series 
Home Health Agency Manual 
Subchapter Number and Title 
Table of Contents 
Page 
vi 
Transmittal Letter 
HHA-47 
Date 
12/01/12 

6. Service Codes and Descriptions ................................. 6-1 
Appendix A. Directory ............................. A-1 
Appendix B. Enrollment Centers........................................... B-1 
Appendix C. Third-Party Liability Codes 
........................................................... C-1 
Appendix D. Supplemental Instructions for TPL Exceptions 
............................................... D-1 
Appendix E. Criteria for Provider Liability............................. 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 and Messages............................ Y-1 
Appendix Z. EPSDT/PPHSD Screening Services Codes............. Z-1