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
TRANSMITTAL LETTER SAT-13
September 2003
TO:      Substance Abuse Treatment Providers Participating in MassHealth FROM:      Douglas S. Brown, Acting Commissioner 
RE:      Substance Abuse Treatment Manual (Revised Service Codes and Descriptions)
This letter transmits revisions to the service codes and descriptions in Subchapter 6 of the Substance Abuse Treatment Manual . These revisions are effective October 1, 2003.
Revised Subchapter 6
Effective for dates of service on or after October 1, 2003, certain billing codes for substance abuse treatment services and/or service descriptions have changed. The Centers for Medicare and Medicaid Services (CMS) has revised the Healthcare Common Procedure Coding System (HCPCS) for 2003. New national service codes have been added, and MassHealth local codes have been removed.
Please see the attached revised Subchapter 6 for complete information on applicable substance abuse treatment service codes. Also attached is a crosswalk that shows the obsolete MassHealth local service codes and the new national service codes.
Claims Submission
For dates of service before October 1, 2003, providers must use the local codes regardless of when the claim is submitted. However, for dates of service on or after October 1, 2003, local codes will not be accepted. Providers, therefore, must bill using the new national service codes from the revised Subchapter 6 for dates of service on or after October 1, 2003.

MASSHEALTH
TRANSMITTAL LETTER SAT-13 September 2003 Page 2
How to Obtain a Substance Abuse Treatment Services Fee Schedule with the New Service Codes
Providers who want to obtain a fee schedule with the new service codes may purchase Division of Health Care Finance and Policy regulations from either the Massachusetts State Bookstore or from the Division of Health Care Finance and Policy (see addresses and telephone numbers below). Providers must contact them first to find out the price of the publication. The Division of Health Care Finance and Policy also has the regulations on disk and on their Web site www.mass.gov/dhcfp. The regulation title is 114.3 CMR 46.00: Rates for Certain Substance Abuse Programs.

Massachusetts State Bookstore State House, Room 116 Boston, MA 02133 Telephone: 617-727-2834 www.mass.gov/sec/spr
Web Site Access and Questions

Division of Health Care Finance and Policy Two Boylston Street Boston, MA 02116 Telephone: 617-988-3100 www.mass.gov/dhcfp

This transmittal letter and the revised regulations are available on the Division’s Web site at www.mass.gov/dma.
If you have any questions, please call MassHealth Provider Services at 617-628-4141 or 1-800-325-5231.
NEW MATERIAL
(The pages listed here contain new or revised language.)
Substance Abuse Treatment Manual
Pages 6-1 and 6-2
OBSOLETE MATERIAL
(The pages listed here are no longer in effect.)
Substance Abuse Treatment Manual
Pages 6-1 and 6-2—transmitted by Transmittal Letter SAT-9

MassHealth
Transmittal Letter SAT-13
September 2003
Attachment
Page 1
Substance Abuse Treatment Center Service Code Crosswalk

Obsolete Code	Obsolete Service Description	New Code	Modifier	New Service Description	Additional Description and/or Unit	
X2194	Individual substance abuse treatment counseling, per 30-minute unit (two units maximum per session)	H0004		Behavioral health counseling and therapy, per 15 minutes	Individual counseling, four units maximum per session	
X2195	Family/couple substance abuse treatment counseling, per 30-minute unit (two units maximum per session)	T1006		Alcohol and/or substance abuse services, family/couple counseling	Per 30-minute unit; two units maximum per session	
X2196	Group substance abuse treatment counseling, per 45-minute unit (two units per session required)	H0005		Alcohol and/or drug services; group counseling by a clinician	Per 45-minute unit; two units maximum per session	
X2197	Individual methadone counseling, per 30-minute unit (two units per session)	H0020	TF	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) (intermediate level of care)	Per 30-minute unit; two units maximum per session; individual counseling	
X2198	Family/couple methadone counseling, per 30-minute unit (two units maximum per session required)	H0020	HR	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) (family/couple with client present)	Per 30-minute unit; two units maximum per session	
X2199	Group methadone counseling, per 45-minute unit (two units per session required)	H0020	HQ	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) (group setting)	Per 45-minute unit; two units maximum per session required	
X2200	Administration or dispensing of one dose of methadone	H0020		Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	Dose only visit	
X2201	Inpatient care in a substance abuse detoxification facility with over 20 beds, per day (Level III-A)	H0011		Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)	Level III-A	
X2202	Inpatient care in a substance abuse detoxification facility with 20 or fewer beds, per day (Level III-A)	H0011		Alcohol and/or drug services; acute detoxification (residential addiction program inpatient)	Level III-A	
X2203	Acupuncture detoxification after first two weeks, per 60-minute unit	97780	HF	Acupuncture, one or more needles, without electrical stimulation (substance abuse program)	Per 60-minute unit	
X2204	Case consultation for substance abuse treatment, per 30-minute unit (two units maximum per session).	90882	HF	Environmental intervention for medical management purposes on a psychiatric patient’s behalf with agencies, employers, or institutions (substance abuse program)	Case consultation, per
30-minute unit,
two units maximum per
session	
X2205	Acupuncture detoxification first two weeks, per 60-minute unit	97780	HF	Acupuncture, one or more needles, without electrical stimulation (substance abuse program)	Per 60-minute unit	

MassHealth
Transmittal Letter SAT-13
September 2003
Attachment
Page 2
Substance Abuse Treatment Center Service Code Crosswalk

Obsolete Code	Obsolete Service Description	New Code	Modifier	New Service Description	Additional Description and/or Unit	
X2210	Individual substance abuse counseling as part of a treatment plan for a special women's shelter program, 30 minutes per unit	H0004		Behavioral health counseling and therapy, per 15 minutes	Individual counseling, four units maximum per session	
X2211	Group substance abuse counseling as part of a treatment plan for a special women's shelter program, 45 minutes per unit	H0005		Alcohol and/or drug services, group counseling by a clinician	Per 45-minute unit, two units maximum per session	
X2212	Family/couple substance abuse counseling as part of a treatment plan for a special women's shelter program, 30 minutes per unit	T1006		Alcohol and/or substance abuse services, family/couple counseling	Per 30-minute unit, two units maximum per session	
X2213	Case consultation as part of a substance abuse treatment plan associated with a special women's shelter program, 30 minutes per unit	90882	HF	Environmental intervention for medical management purposes on a psychiatric patient’s behalf with agencies, employers, or institutions (substance abuse program)	Per 30-minute unit; two units maximum per session	
X2214	Enhanced inpatient drug detoxification (20 beds or fewer) (one unit maximum per day) (Level III-A)	H0011	HD	Alcohol and/or drug services, acute detoxification (residential addiction program inpatient) (pregnant parenting women’s program)	Level III-A	
X2215	Enhanced inpatient drug detoxification (over 20 beds) (one unit maximum per day) (Level III-A)	H0011	HD	Alcohol and/or drug services, acute detoxification (residential addiction program inpatient) (pregnant parenting women’s program)	Level III-A	
X2216	Individual substance abuse treatment counseling, per 30-minute unit (two units maximum per day)	H0004	HD	Behavioral health counseling and therapy, per 15 minutes (pregnant parenting women’s program)	Individual, four units maximum per day	
X2217	Family/couple substance abuse treatment counseling, per 30-minute unit (two units maximum per day)	T1006	HD	Alcohol and/or substance abuse services, family/couple counseling (pregnant parenting women’s program)	Per 30-minute unit, two units maximum per day	
X2218	Group substance abuse treatment counseling, per 45-minute unit (two units maximum per day)	H0005	HD	Alcohol and/or drug services, group counseling by a clinician (pregnant parenting women’s program)	Per 45-minute unit, two units maximum per day	
X2219	Case management substance abuse treatment counseling, per 45-minute unit (two units maximum per day)	H0006	HD	Alcohol and/or drug services, case management (pregnant parenting women’s program	Per 15-minute unit, four units maximum per day	
X2220	Day treatment (includes group counseling and case management), per four-hour unit (one unit maximum per day)	H1005	HQ	Prenatal care, at-risk enhanced service package (includes H1001-H1004) (group setting)	Prenatal care, at-risk enhanced service, antepartum management/care coordination/education/ follow-up home visit, per four hour unit, one unit maximum per day	

MassHealth
Transmittal Letter SAT-13
September 2003
Attachment
Page 3
Substance Abuse Treatment Center Service Code Crosswalk

Obsolete Code	Obsolete Service Description	New Code	Modifier	New Service Description	Additional Description and/or Unit	
X2221	Day treatment, individual counseling, per one-hour unit (one unit maximum per day).	H1005		Prenatal care, at-risk enhanced service package (includes H1001-H1004)	Prenatal care, at-risk enhanced service, antepartum management/care coordination/education/ follow-up home visit, individual counseling, per one hour unit, one unit maximum per day	
X2230	Enhanced acute treatment (Level III-B)	H0010		Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)	Under 21 only, Level III-B	
X2231	Inpatient substance abuse care provided in a non-hospital, substance abuse treatment facility. Enhanced acute treatment, (Level III-C)	H0010	52	Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) (reduced services)	Under 21 only, Level III-C	
X2232	Enhanced acute treatment for pregnant recipients, Level III-B	H0010		Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient)	Level III-B, under 21 only	
X2233	Enhanced acute treatment for pregnant recipients (Level III-C)	H0010	52	Alcohol and/or drug services; sub-acute detoxification (residential addiction program inpatient) (reduced services)	Level III-C, under 21 only,	

Commonwealth of Massachusetts
Division of Medical Assistance
Provider Manual Series
SUBSTANCE ABUSE TREATMENT MANUAL	SUBCHAPTER NUMBER AND TITLE
6 SERVICE CODES AND DESCRIPTIONS	PAGE
6-1	

	TRANSMITTAL LETTER
SAT-13	DATE
10/01/03	
601 Service Codes and Descriptions
Service Code    Modifier Service Description
Inpatient Services
H0011	Alcohol and/or drug services acute detoxification (residential addiction program
inpatient) (Level III-A)
H0010	Alcohol and/or drug services sub-acute detoxification (residential addiction program
inpatient) (Level III-B) (under 21 only)
H0010   52	Alcohol and/or drug services sub-acute detoxification (residential addiction program
inpatient) (reduced services) (Level III-C) (under 21 only)
Methadone Services
H0020	Alcohol and/or drug services methadone administration and/or service (provision of the
drug by a licensed program) (dose only visit)
H0020   TF	Alcohol and/or drug services methadone administration and/or service (provision of the
drug by a licensed program) (intermediate level of care) (per 30-minute unit, two units
maximum per session) (individual counseling)
H0020   HR	Alcohol and/or drug services methadone administration and/or service (provision of the
drug by a licensed program) (family/couple with client present) (per 30-minute unit, two
units maximum per session)
H0020   HQ	Alcohol and/or drug services methadone administration and/or service (provision of the
drug by a licensed program) (group setting) (per 45-minute unit, two units maximum per
session required)
Outpatient Services
90882    HF	Environmental intervention for medical management purposes on a psychiatric patient’s
behalf with agencies, employers, or institutions (substance abuse program) (case consultation) (per 30-minute unit two units maximum per session)
97780    HF	Acupuncture, one or more needles, without electrical stimulation (substance abuse
program) (per 60-minute unit) (I.C.)
H0004	Behavioral health counseling and therapy, per 15 minutes (individual counseling) (four
units maximum) (per session)
H0005	Alcohol and/or drug services group counseling by a clinician (per 45-minute unit) (two
units maximum)
T1006	Alcohol and/or substance abuse services family/couple counseling (per 30-minute unit,
two units maximum per session)

Commonwealth of Massachusetts
Division of Medical Assistance
Provider Manual Series
SUBSTANCE ABUSE TREATMENT MANUAL	SUBCHAPTER NUMBER AND TITLE
6 SERVICE CODES AND DESCRIPTIONS	PAGE
6-2	

	TRANSMITTAL LETTER
SAT-13	DATE
10/01/03	
601 Service Codes and Descriptions (cont.)
Service Code   Modifier Service Description
Enhanced Inpatient Detoxification Services for Pregnant Recipients
H0011   HD        Alcohol and/or drug services acute detoxification (residential addiction program inpatient) (pregnant/parenting women’s program) (Level III-A)
Intensive Outpatient Detoxification Services for Pregnant Recipients
H0004   HD        Behavioral health counseling and therapy, per 15 minutes (pregnant/parenting women’s
program) (individual) (four units maximum per day) T1006   HD        Alcohol and/or substance abuse services family/couple counseling (pregnant/parenting
women’s program) (per 30-minute unit) (two units maximum per day) H0005   HD        Alcohol and/or drug services group counseling by a clinician (pregnant/parenting women’s
program) (per 45-minute unit) (two units maximum per day) H0006   HD        Alcohol and/or drug services case management (pregnant/parenting women’s program)
(per 15 minute unit) (four units maximum per day)
Day Treatment Program for Pregnant Recipients
H1005	Prenatal care, at-risk enhanced service package (includes H1001-H1004) (prenatal care,
at-risk enhanced service antepartum management/care coordination/education/follow-up home visit) (individual counseling) (per one hour unit, one unit maximum per day)
H1005   HQ	Prenatal care, at-risk enhanced service package (includes H1001-H1004) (group setting)
(prenatal care, at-risk enhanced service antepartum management/care coordination/education/follow-up home visit) (per four hour unit) (one unit maximum per day)