Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth
	MassHealth
	Acute Outpatient Hospital Bulletin 23
	September 2010




	TO:	Acute Outpatient Hospitals Participating in MassHealth

	FROM:	Terence G. Dougherty, Medicaid Director

	RE:	Updated Drug Screen Testing Unit Limitation


Drug Screen Unit Limitation 	Effective October 1, 2010, the maximum allowable units that MassHealth 
	will pay for Service Codes 80100 (Drug screen, qualitative; multiple drug 
classes chromatographic method, each procedure) and 80101 (Drug 
screen, qualitative; single drug class method (e.g., immunoassay, 
enzyme assay), each drug class) is eight units for each date of service.  
This policy brings MassHealth in line with firmly established community 
and national standards governing appropriate clinical use of drug 
screening services and ensures that MassHealth pays for only medically 
necessary services. 

Providers may request additional units when medically necessary by 
requesting prior authorization (PA). The request for PA must demonstrate 
medical necessity for testing the patient for more than eight specific drug 
classes per date of service. Providers should refer to Subchapter 5, Part 
2 of the Administrative and Billing Instructions for information about the 
PA process. This information is also accessible through the MassHealth 
Web site. Go to www.mass.gov/masshealthpubs. Click on Provider 
Library, then on MassHealth Provider Manuals, then on Acute Outpatient 
Hospital Manual. 
  

Questions	If you have any questions about the information in this bulletin, please 
contact MassHealth Customer Service at 1-800-841-2900, e-mail your 
inquiry to providersupport@mahealth.net, or fax your inquiry to 
617-988-8974.