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Coronavirus Disease 2019 (COVID-19)—Provider Rate Information

Information on adjusted essential provider rates related to the COVID-19 emergency.

Table of Contents

EOHHS Administrative Bulletins

Administrative Bulletin 23-11: 101 CMR 204.00: Rates of Payment to Resident Care Facilities: Anticipated Updates to COVID-19 Surveillance Testing Payments for Resident Care Facilities, effective May 1, 2023, describes the intended end to surveillance testing payments to resident care facilities to algin with the announcement by the Department of Public Health about the end of the surveillance testing requirements and supersedes any relevant provisions in Administrative Bulletins 20-73, 20-81, 20-90, 21-09, 21-13, and 21-21. PDF | Word

Administrative Bulletin 22-02: Payment Methodologies for New and Existing Nursing Facility Payments under 101 CMR 206.00: Standard Payments to Nursing Facilities implements, effective beginning January 15, 2022, certain payment methodologies for new and existing nursing facility rate add-on and supplemental rate payments under 101 CMR 206.00: Standard Payments to Nursing Facilities. PDF | Word

Administrative Bulletin 21-29: Payment for Coronavirus Disease 2019 (COVID-19) Vaccines Administered by Resident Care Facilities states that, effective for dates of service as specifically listed within this bulletin, resident care facilities that meet DPH eligibility criteria for administration of COVID-19 vaccinations, may receive payment for administering of COVID-19 vaccines at the rates identified by the bulletin. PDF | Word

Administrative Bulletin 21-21: 101 CMR 204.00: Rates of Payment to Resident Care Facilities: Updated COVID-19 Ongoing Surveillance Testing Requirements for Nursing Facilities supersedes AB 21-13 to align with Department of Public Health surveillance testing requirements, (effective August 12, 2021) PDF | Word

Administrative Bulletin 21-20: 101 CMR 613.00: Health Safety Net Eligible Services\101 CMR 614.00: Health Safety Net Payments and Funding: Health Safety Net Service and Reimbursement for COVID-19 Vaccines and Related Services (effective July 26, 2021) PDF | Word

Administrative Bulletin 21-18: 101 CMR 320.00: Clinical Laboratory Services: Procedure Code Update (effective January 25, 2021) PDF | Word

Administrative Bulletin 21-15: 101 CMR 613.00: Health Safety Net Eligible Services\101 CMR 614.00: Health Safety Net Payments and Funding: Health Safety Net Service and Reimbursement Policy Flexibilities Related to the 2019 Novel Coronavirus Disease 2019 (COVID-19) (effective June 15, 2021) PDF | Word

Administrative Bulletin 20-80: 101 CMR 614.00: Health Safety Net Payments and Funding provides guidance on additional flexibilities for pharmacy coverage and billing for individuals who are Health Safety Net patients, and provides guidance on additional flexibilities for pharmacy coverage and billing for individuals who are Health Safety Net patients. PDF | Word

Administrative Bulletin 20-76: 101 CMR 613.00: Health Safety Net Eligible Services\101 CMR 614.00: Health Safety Net Payments and Funding: Health Safety Net Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID-19) (effective August 14, 2020) PDF | Word

Administrative Bulletin 20-75: 101 CMR 327.00: Rates of Payment for Ambulance and Wheelchair Van Services:  Ambulance and Wheelchair Van Services Code Update PDF | Word

Administrative Bulletin 20-74: 101 CMR 358.00: Rates of Payment for Applied Behavior Analysis: Applied Behavior Analysis Code Update PDF | Word

Administrative Bulletin 20-72: 101 CMR 310.00: Adult Day Health Services (effective July 1, 2020) PDF | Word

Administrative Bulletin 20-71: 101 CMR 348.00: Day Habilitation Program Services (effective July 1, 2020) PDF | Word

Administrative Bulletin 20-70: 101 CMR 359.00: Rates for Home and Community Based Services Waivers (effective July 10, 2020) PDF  | Word

Administrative Bulletin 20-69: 101 CMR 206.00: Standard Payments to Nursing Facilities (effective July 1, 2020) PDF  | Word

Administrative Bulletin 20-68: 101 CMR 206.00: Standard Payments to Nursing Facilities (effective July 10, 2020) PDF | Word

Administrative Bulletin 20-67: 101 CMR 309.00: Rate for Certain Services for the Personal Care Attendant Program (effective July 1, 2020) PDF | Word

Administrative Bulletin 20-64: 101 CMR 331.00:  Prescribed Drugs: Payment Adjustment to Professional Dispensing Fee (effective June 17, 2020) PDF | Word

Administrative Bulletin 20-63: 101 CMR 361.00: Rate for Continuous Skilled Nursing Services: Rate Add-On Applicable to Certain Continuous Skilled Nursing Services to Address Costs Associated with Coronavirus Disease 2019 (COVID-19) (effective June 17, 2020) PDF | Word

Administrative Bulletin 20-62: 101 CMR 316.00: Surgery and Anesthesia, 101 CMR 317.00: Medicine, 101 CMR 318.00: Radiology: Alternative Interim Payment Methodology Applicable to Physicians (effective June 16, 2020) - UPDATED (New due date for applications) PDF | Word

Administrative Bulletin 20-61: 101 CMR 314.00: Dental Services: Alternative Interim Payment Methodology Applicable to Dentists (effective June 16, 2020) - UPDATED (New due date for applications) PDF | Word

Administrative Bulletin 20-56: 101 CMR 320.00: Clinical Laboratory Services: Procedure Code Modifier Relating to Testing for COVID-19 (effective May 29, 2020) PDF | Word

Administrative Bulletin 20-55: 101 CMR 206.00: Standard Payments to Nursing Facilities: Supplemental Payments for Certain Nursing Facilities to Complete COVID-19 Baseline Testing Requirements During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective May 29, 2020) PDF | Word

Administrative Bulletin 20-54: 101 CMR 359.00:  Rates for Home and Community Based Services Waivers: Additional Rate Provision Applicable to Providers of Day Services to Address Changes in Service Modalities Associated with Coronavirus Disease 2019 (COVID-19) (effective May 29, 2020) PDF | Word

Administrative Bulletin 20-53: 101 CMR 206.00  Standard Payments to Nursing Facilities: Accountability and Support Supplemental Payment Methodology Applicable to Nursing Facilities During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective May 15, 2020) PDF | Word

Appendix A: Accountability and Support Administrative Bulletin PDF | XLS

Payments per Section 3 of Administrative Bulletin 20-53: Accountability and Support Supplemental Payment Methodology Applicable to Nursing Facilities During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency PDF l XLS

Administrative Bulletin 20-49: 101 CMR 613.00: Health Safety Net Eligible Services: Health Safety Net Coverage and Reimbursement Policy for Pharmacy Services During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency​ temporarily removes the limit on the number of times a 340B provider may fill prescriptions from its retail stock for Health Safety Net patients who are not the 340B provider’s regular patients. PDF | Word

Administrative Bulletin 20-48: 101 CMR 206.00: Standard Payments to Nursing Facilities: Supplemental Payment Methodology Applicable to Certain Nursing Facilities During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective May 12, 2020) PDF | Word

Administrative Bulletin 20-46: 101 CMR 358.00: Rates of Payment for Applied Behavior Analysis: Rate Update Applicable to Certain Applied Behavior Analysis Services During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective May 11, 2020) PDF | Word

Administrative Bulletin 20-45: 101 CMR 322.00: Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment: Procedure Code Update Applicable to Distribution Services by Durable Medical Equipment (DME) Providers Related to Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective May 11, 2020) PDF | Word

Administrative Bulletin 20-44: 101 CMR 320.00: Clinical Laboratory Services: Procedure Code and Rate Update Relating to Testing for COVID-19 (effective May 11, 2020) PDF | Word

Administrative Bulletin 20-40:  Establishment of Bundled Rate for Remote Patient Monitoring Services During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective May 9, 2020) PDF | Word

Administrative Bulletin 20-37: 101 CMR 206.00: Standard Payments to Nursing Facilities: Supplemental Payment Methodology Applicable to Certain Nursing Facilities During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective April 24, 2020) PDF | Word

Administrative Bulletin 20-36: 101 CMR 327.00:  Rates of Payment for Ambulance and Wheelchair Van Services: Procedure Code Update During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective April 23, 2020) PDF | Word

Administrative Bulletin 20-35: 101 CMR 359.00: Rates for Home and Community Based Services Waivers: Rate Adjustment Applicable to Certain Acquired Brain Injury (ABI) and Moving Forward Plan (MFP) Waiver Services to Address Costs Associated with Coronavirus Disease (COVID-19) (effective April 23, 2020) PDF | Word

Administrative Bulletin 20-34: 101 CMR 348.00: Day Habilitation Program Services: Additional Rate Provisions Applicable to Certain Day Habilitation Program Providers to Compensate for Costs Associated with Coronavirus Disease 2019 (COVID-19) (effective April 23, 2020) PDF | Word

Administrative Bulletin 20-33: 101 CMR 310.00: Adult Day Health Services: Additional Rate Provisions Applicable to Certain Adult Day Health Providers to Compensate for Costs Associated with Coronavirus Disease 2019 (COVID-19) (effective April 23, 2020) PDF | Word

Administrative Bulletin 20-32: 101 CMR 329.00: Psychological Testing, Treatment, and Related Services: Rate Update Applicable to Certain Psychological Services During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective April 23, 2020) PDF | Word

Administrative Bulletin 20-30:  101 CMR 304:00: Rates for Community Health Centers: Alternative Payment Methodology Applicable to Community Health Centers Providing Services at Coronavirus Disease 2019 (COVID-19) Isolation and Recovery Sites (effective April 22, 2020) PDF | Word

Administrative Bulletin 20-29: 101 CMR 327.00:  Rates of Payment for Ambulance and Wheelchair Van Services: Rate Update Applicable to Certain Ambulance Services During the COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-28: 101 CMR 358.00: Rates of Payment for Applied Behavior Analysis: Rate Update Applicable to Certain Applied Behavior Analysis Services During the COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-27: 101 CMR 316.00:  Surgery and Anesthesia, 101 CMR 317.00:  Medicine, 101 CMR 318.00:  Radiology: Rate Update Applicable to Certain Physician Services During the COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-26: 101 CMR 304.00: Rates for Community Health Centers: Supplemental Payment Methodology Applicable to Community Health Centers During the COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-25: 101 CMR 309.00: Rate for Certain Services for the Personal Care Attendant Program: Rate Adjustment Applicable to Certain Personal Care Attendant Services to Address Costs Associated with COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-24: 101 CMR 350.00: Home Health Services: Rate Adjustment Applicable to Certain Home Health Services to Address Costs Associated with COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-23: 101 CMR 361.00: Rate for Continuous Skilled Nursing Services: Rate Adjustment Applicable to Certain Continuous Skilled Nursing Services to Address Costs Associated with COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-20: 101 CMR 206.00: Standard Payments to Nursing Facilities: Supplemental Payment Methodology Applicable to Nursing Facilities During the COVID-19 Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-19: 101 CMR 206.00: Standard Payments to Nursing Facilities: Payments for COVID-19 Nursing Facilities (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-18: 101 CMR 327.00:  Rates of Payment for Ambulance and Wheelchair Van Services: Updated Rate for Certain Ambulance Services During the COVID-19 Public Health Emergency (effective April 10, 2020) PDF | Word

Administrative Bulletin 20-15: 101 CMR 352.00: Rates of Payment for Certain Children’s Behavioral Health Services: Rate Update Applicable to Certain Children’s Behavioral Health Initiative Services During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-14: 101 CMR 430.00: Rates for Program of Assertive Community Treatment Services: Rate Update Applicable to Certain Program for Assertive Community Treatment Services During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (effective April 16, 2020) PDF | Word

Administrative Bulletin 20-11: Add-On Rate Applicable to Certain Social Service Programs to Compensate for Costs Associated with Coronavirus (COVID-19) (effective April 2, 2020)  PDF | Word

Administrative Bulletin: 20-09: 101 CMR 613.00: Health Safety Net Eligible Services; 101 CMR 614.00: Health Safety Net Payments and Funding: Health Safety Net Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID-19) establishes provider flexibilities and expanded coverage consistent with MassHealth’s fee for service program PDF | Word

Last updated: January 11, 2023

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