Commonwealth of Massachusetts 
Executive Office of Health and Human Services 
Division of Medical Assistance 
600 Washington Street
Boston, MA 02111


MassHealth 
Acute Inpatient Hospital Bulletin 118 
November 2000 

TO: Acute Inpatient Hospitals Participating in MassHealth 

FROM: Wendy E. Warring, Commissioner 

RE: Rebilling Denied Inpatient Admissions as Outpatient Services 

Background

To assist acute hospitals to rebill certain denied inpatient admissions as 
outpatient claims, the Division is issuing the attached information sheet. 
This information pertains only to services billed on the UB-92 claim 
form. 

Information

Effective June 11, 1999, for inpatient claims denied by MassPRO through 
the Prepayment and Postpayment Review Programs because of a lack of 
medical necessity for the inpatient setting, the Division allows acute 
hospitals to rebill these services as outpatient services (See 130 CMR 
415.414 (B)). The Division has prepared the attached information sheet 
as an aid to hospitals preparing and submitting such outpatient claims. 

Please be sure to provide the attached information sheet to the 
departments that are responsible for rebilling the denied claims. 

Questions

If you have any questions regarding preparing and submitting outpatient 
claims, please call the MassHealth Provider Services Department at 
(617) 628-4141 or 1-800-325-5231.