Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111	
	MassHealth
Audiologist Bulletin 2
January 2004

	TO:	Audiologists Participating in MassHealth

	FROM:	Beth Waldman, Director,  Office of Medicaid

	RE:	Revisions to Service Limits on Office Visits for Evaluation and Management Services

Introduction	In September 2003, MassHealth issued Transmittal Letter AUD-10.  

The crosswalk of service codes accompanying the Transmittal Letter AUD-10 incorrectly limited office visits for evaluation and management services (Service Code 99499) to a maximum of one unit per member per date of service.   

Correction 	Effective for dates of service beginning October 1, 2003, MassHealth will pay for a maximum of six units per member per date of service for Service Code 99499 (unlisted evaluation and management service).

For members under age 21, providers may seek prior authorization pursuant to 130 CMR 450.144(A) for units in excess of six per member per date of service.  To obtain prior authorization, a provider must demonstrate that more than six units per member per date of service are medically necessary.

For dates of service on and after October 1, 2003, providers can submit adjustments for claims that were paid for only one unit of service when more than one unit was provided.  Providers who submitted claims in the 837-Professional format can submit void and replace transactions.

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