Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth All Provider Bulletin 204 June 2010 TO: All Providers Participating in MassHealth FROM: Terence G. Dougherty, Medicaid Director RE: Revised Billing Instructions for Healthy Start Program (HSP) Providers Background The Healthy Start Program (HSP) covers low-income pregnant women who, except for MassHealth Limited, are not eligible for MassHealth and have no other health insurance that covers pregnancy-related care. All HSP women/ members are covered by MassHealth Limited. On the MassHealth Eligibility Verification System (EVS), these members will have the coverage type “Limited plus Healthy Start” under the “eligibility status” field. HSP is currently administered by a vendor, UniCare, and typically covers prenatal and postpartum care, but not labor and delivery. MassHealth Limited provides coverage for labor and delivery, among other services. Current Billing Currently, providers billing a labor and delivery global code for an HSP Instructions member must submit a claim to both UniCare and MassHealth to receive full payment. Providers today must submit prenatal and postpartum care claims to UniCare, which pays a reduced rate for the global delivery code. To receive payment for the remainder of the global delivery code, covering labor and delivery, providers today must submit a claim to MassHealth. New Billing Effective for dates of service beginning July 1, 2010, providers billing global Instructions delivery codes for HSP members should submit claims only to MassHealth. HSP claims for these global codes should no longer be submitted to UniCare. The global delivery codes are 59400, 59410, 59510, 59515, 59610, 59614, 59618, and 59622. Global code labor and delivery claims submitted to UniCare for dates of service on or after July 1, 2010, will be denied. Providers properly following this new procedure will be paid the full allowable rate set by the Division of Health Care Finance and Policy. Questions If you have any questions about the information in this bulletin, please contact MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974.