Commonwealth of Massachusetts
Executive Office of Health and Human Services
Division of Medical Assistance
600 Washington Street
Boston, MA  02111
www.mass.gov/dma	
	MassHealth
	Acute Outpatient Hospital Bulletin 4
	March 2002

	TO:	Acute Outpatient Hospitals and Hospital Licensed Health Centers Participating in MassHealth

	FROM:	Wendy E. Warring, Commissioner

	RE:	Maximum Billable Units for Certain Services Provided by Acute Outpatient Hospitals

Introduction	The Division is issuing this bulletin to respond to requests from acute outpatient hospitals to clarify the maximum units that may be billed for certain services on the UB 92 claim form. Claims with dates of service on or after April 15, 2002 that have units billed in excess of those listed below, will be denied.

	This bulletin does not change any other Division policy or rate of payment.  

Revenue Codes
and Maximum Units
	
Revenue Code and Service Description
	
Maximum Units	
	
370	Anesthesia, general
	
1	
	
371	Anesthesia incident to radiology
	
1	
	
372	Anesthesia incident to other diagnostic 
services
	
1	
	
413	Hyperbaric oxygen therapy  (The technical 
component for hyperbaric oxygen therapy should be billed on the UB 92 using Service Code 99183.

1	
	
636	Drugs requiring detailed coding
	
1	

Questions	Contact MassHealth Provider Services at 617-628-4141 or 
	1-800-325-5231 with any questions about this bulletin.