Commonwealth of Massachusetts 
Executive Office of Health and Human Services 
Division of Medical Assistance 

600 Washington Street 
Boston, MA 02111 


MassHealth 
Municipally Based Health Services Bulletin 7 
October 2000 

TO: Municipally Based Health Services Providers Participating in MassHealth 

FROM: Wendy E. Warring, Commissioner 

RE: Increased Per Diem Rates 

Background The per diem rates for municipally based health services for special-
education students have been revised effective December 1, 1999. 

New Rates Providers should use the rates listed below to bill for services provided to 
MassHealth members on or after December 1, 1999. 

Prototype 
Service 
Code 
Service 
Description Rate 
502.8 X7668 Early Childhood $120.79/week 
502.6 X7666 .6 Residential Placement 
and .5 Cost Share 
$52.67/day 
502.5 X7665 .5 Day Placement $50.62/day 
502.4 X7664 .4 Separate Placement $26.95/day 
502.1, 
502.2, 502.3 
X7663 Public Day Program $12.41/day 

Adjustment Claims To receive the difference between the previous rate and the new rate for 
claims for dates of service on or after December 1, 1999, that have 
already been paid at the old rate, providers may submit adjustment 
claims. 
Questions If you have any questions about this bulletin, including how to prepare 
adjustment claims, please call the MassHealth Provider Services 
Department at (617) 628-4141 or 1-800-325-5231.