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Guide Home Health Agency (HHA) Manual

The Home Health Agency Manual contains the regulations, administrative and billing instructions, and service codes for home health agencies. The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. See 101 CMR 350.00. MassHealth issues transmittal letters to update any part of the provider manual. MassHealth issues provider bulletins to communicate information that is not contained in the provider manual. Each part of the Home Health Agency Manual is listed below from beginning to end. You can print each part separately (or any individual pages) or print all parts for a complete manual.

Table of Contents

Table of Contents

  • Table of contents pages i, ii, ii-a, and iii appear at the beginning of Subchapter 1 below.
  • Table of contents page iv appears at the beginning of Subchapter 4 below.
  • Table of contents page v (see below)
  • Table of contents page vi (see below)

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Preface

See below for the Home Health Agency (HHA) Manual Preface.

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Subchapters 1 through 3

Administrative and Billing Regulations (apply to all providers).

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Subchapter 4

See below for the Home Health Agency (HHA) regulations (130 CMR 403.000).

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Subchapter 5

The Administrative and Billing Instructions (Subchapter 5) are divided into seven parts. For instructions for electronic billing, refer to the MassHealth Companion Guides. To request a copy of any of the MassHealth Companion Guides please contact MassHealth Customer Service Center at 1-800-841-2900. For instructions for billing MassHealth using paper claim forms refer to MassHealth Billing Guides for Paper Claim Submitters.

Please see below for Subchapter 5: Administrative and Billing Instructions.

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Subchapter 6

See below for service codes for the Home Health Agency (HHA) Manual.

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MassHealth All Provider Manual Appendices

The MassHealth generic appendices contained in all provider manuals (Appendices A, C, T, U, V, W, X, Y, and Z).

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Home Health Agency Manual Appendices

Appendix D: Supplemental Instructions for TPL Exceptions

This appendix contains billing instructions for submitting 837I and 837P transactions, paper claims, and direct data entry (DDE) claims for members who have Medicare or commercial insurance, and whose services are determined not covered by the primary insurer. This appendix lists the exceptions that need to be considered when billing MassHealth, for members who have Medicare or commercial insurance. These are specific MassHealth billing instructions that are not described in the HIPAA implementation guides for the 837I and 837P transactions, in the 837I and 837P companion guides, or in the billing guides for the UB-04 or CMS-1500 claim forms.

Appendix E: Criteria for Provider Liability

This appendix explains the review criteria that MassHealth uses to determine home health agency liability for invalid home health advanced beneficiary (HHABN) notices.

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