Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth Community Health Center Bulletin 58 December 2005 TO: Community Health Centers Participating in MassHealth FROM: Beth Waldman, Medicaid Director RE: 2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update Introduction The federal government has revised the Healthcare Common Procedure Coding System (HCPCS) that is used for MassHealth billing. For dates of service on or after January 1, 2006, service codes that have been discontinued by the Centers for Medicare and Medicaid Services (CMS) and deleted by the American Medical Association Current Procedural Terminology (CPT) for 2006 will no longer be payable by MassHealth. Services described by these codes may be billed with replacement codes. Replacement codes are Level I and Level II HCPCS codes from any year, including 2006, that replace the 2006 "deleted" codes. MassHealth will pay only for new 2006 HCPCS code additions that are replacing the 2006 deleted codes. MassHealth is not adopting any other 2006 HCPCS code additions at this time. MassHealth will review the rest of the 2006 HCPCS code additions and changes and will determine coverage policies and other requirements at a later date. Providers will receive a transmittal letter and updated Subchapter 6 of their provider manual when the final review of 2006 HCPCS code additions has been completed. The 2006 deleted codes and HCPCS additions that are payable for dates of service on or after January 1, 2006, are attached to this bulletin. Payment The 2006 HCPCS code additions attached to this bulletin are payable services in addition to the list of services described in Subchapter 6 of your provider manual. In accordance with MassHealth regulations, payments are subject to the terms and conditions of 130 CMR 405.000 and 450.000. MassHealth Community Health Center Bulletin 58 December 2005 Page 2 Payment Requirements Payment for these new codes will be determined through individual consideration (I.C.) until the Division of Health Care Finance and Policy (DHCFP) establishes specific rates and these rates are incorporated into the appropriate regulation. Questions MassHealth Customer Service at 1-800-841-2900, email your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974. MassHealth Community Health Center Bulletin 58 December 2005 Attachment Updates to the List of MassHealth-Payable Codes for Community Health Centers Listed below are the service codes that replace HCPCS codes that have been deleted for 2006 and are payable by MassHealth for dates of service on or after January 1, 2006. These service codes are covered under individual consideration until the Division of Health Care Finance and Policy (DHCFP) establishes specific rates and these rates are incorporated into the appropriate regulation. Providers should refer to www.cms.hhs.gov for service descriptions. 82271 83700 83701 99051 99053 99060 99304 99305 99306 99307 99308 99309 99310 99324 99325 99326 99327 99334 99335 99336 99337 Discontinued Service Codes for Community Health Centers The following service codes are deleted for 2006 and are not payable by MassHealth for dates of service on or after January 1, 2006. Providers should refer to www.cms.hhs.gov for service descriptions. 76375 78160 78162 78170 78172 78455 82273 83715 83716 99054 99301 99302 99303 99311 99312 99313 99321 99322 99323 99331 99332 99333