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Commercial Carriers and QHPs regulated by DOI

Acute care billing instructions for behavioral health services provided by Commercial Carriers and Qualified Health Plans (QHPs) regulated by Department of Insurance (DOI.)

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BH Crisis Evaluation (Required of Hospitals)

On initial day of readiness (S9485, no modifier)

ED-Based	Med/Surg
Plan coverage is plan specific.	Plan coverage is plan specific.

BH Crisis Management

On days subsequent to the initial BH Crisis Evaluation for individuals experiencing a behavioral health crisis in need of ongoing behavioral health crisis supports (S9485-V1 or -V2)

ED-Based	Med/Surg
Plan coverage is plan specific.	Plan coverage is plan specific.

MOUD Induction

Ed- Based Only
Plan coverage is plan specific.

Recovery Support Navigator (RSN)

RSN services provided in the emergency department or medical/surgical floors (H2015-HF)

ED-Based	Med/Surg
Plan coverage is plan specific.	Plan coverage is plan specific.

Date published:	April 30, 2024

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Table of Contents

Commercial Carriers and QHPs regulated by DOI

Table of Contents

BH Crisis Evaluation (Required of Hospitals)

On initial day of readiness (S9485, no modifier)

BH Crisis Management

On days subsequent to the initial BH Crisis Evaluation for individuals experiencing a behavioral health crisis in need of ongoing behavioral health crisis supports (S9485-V1 or -V2)

MOUD Induction

Recovery Support Navigator (RSN)

RSN services provided in the emergency department or medical/surgical floors (H2015-HF)

Help Us Improve Mass.gov with your feedback

Table of Contents

Commercial Carriers and QHPs regulated by DOI

Table of Contents

BH Crisis Evaluation (Required of Hospitals)

On initial day of readiness (S9485, no modifier)

BH Crisis Management

On days subsequent to the initial BH Crisis Evaluation for individuals experiencing a behavioral health crisis in need of ongoing behavioral health crisis supports (S9485-V1 or -V2)

MOUD Induction

For initiation of medication for opioid use disorder in the emergency department for MassHealth members who consent to initiation (G2213)

Recovery Support Navigator (RSN)

RSN services provided in the emergency department or medical/surgical floors (H2015-HF)

Help Us Improve Mass.gov with your feedback