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
	Targeted Case Management Bulletin 1
 	October 2002

	TO:	Targeted Case Management Providers Participating in MassHealth

	FROM:	Wendy E. Warring, Commissioner

	RE:	Changes to Service Code, Service Description, and Per Diem Rate to Units per Day for Services for MassHealth Members Living in Congregate AIDS Housing

Background	The Centers for Medicare and Medicaid Services (CMS) have revised the Healthcare Common Procedure Coding System (HCPCS) for 2002.  New national procedure codes have been added. 

New Service Code	The new national procedure code for Targeted Case Management  
And Description 	(TCM) programs is T1017 – Targeted Case Management, each 15 minutes.  This code is for services to MassHealth members who have been diagnosed with AIDS and who are living in congregate AIDS housing.

	Please note that the unit value has been changed from a per diem rate to 15-minute time increments.

	The maximum number of units that you can bill for each member per day is four.  In order to accommodate this change, your current TCM per diem rate was divided by four.  This will be your new TCM per unit rate.

The new national procedure code is effective for dates of service on or after November 1, 2002.

Crosswalk of Procedure Codes for 
Targeted Case Management (TCM) Providers	
Obsolete TCM Procedure Code	
New National Procedure Code	
Description	
Effective Date	
				
X9876	T1017	Targeted Case Management, each 15 minutes	11/01/02	
Maximum of 4 units per member per day may be billed; 1 unit = 15 minutes	

	

Billing Guidelines	A revised billing guide will follow separately.

Questions	If you have any questions about this bulletin, please contact MassHealth Provider Services at 617-628-4141 or 1‑800‑325-5231.