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 8
September 2003

TO:	Acute Outpatient Hospitals and Hospital-Licensed Health Centers (HLHCs) Participating in MassHealth

FROM:	Douglas S. Brown, Acting Commissioner

RE:	Maximum Billable Units on Revenue Codes and Current Procedural Terminology Codes (CPT-4)

Maximum 			The CPT-4 codes on the attached list represent all payable services for
Units 	MassHealth members, with allowable units that are greater than one. The Division is issuing this list at the request of outpatient hospital providers.

Reminder	Providers are reminded that they may bill only for the actual number of units of services provided to a MassHealth member that are medically necessary on a specific date of service.

Future Updates	The Division will review this list periodically and make updates to reflect any changes to the allowable number of units.  Any CPT-4 codes that are added as a payable service code will also appear on the annual update if more than one unit is allowed.

All other revenue and CPT-4 service codes that are payable by the Division allow for one unit only.

Questions	Providers with questions about this bulletin, should contact MassHealth Provider Services at 617-628-4141 or 1-800-325-5231.