Health New England

Acute care billing for behavioral health services rendered by Health New England (HNE) network providers.

BH Crisis Evaluation (Required of Hospitals)

On initial day of readiness (S9485, no modifier)

ED-Based	Med/Surg
Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff. There are no revenue code limitations. For hospitals billing for the ED crisis eval, claims should be submitted to the plan using S9485 on the UB 04 claim. There are no revenue code limitations. S9485 is paid the MassHealth per diem rate.	Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff. There are no revenue code limitations. Claims should be submitted to the plan using S9485 on the UB 04 claim. There are no revenue code limitations. S9485 is paid the MassHealth per diem rate.

BH Crisis Management

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

ED-Based	Med/Surg
Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff.  There are no revenue code limitations. For hospitals billing for the ED crisis eval, claims should be submitted to the plan using S9485-V1 or -V2 on the UB 04 claim. There are no revenue code limitations. S9485-V1 or -V2 is paid the MassHealth per diem rate.	Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff.  There are no revenue code limitations. Claims should be submitted to the plan using S9485-V1 or V2 on the UB 04 claim. There are no revenue code limitations. S9485 is paid the MassHealth per diem rate.

MOUD Induction

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

Ed- Based Only
Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff. There are no revenue code limitations. For hospitals billing for the ED crisis eval, claims should be submitted to the plan using G2213 on the UB 04 claim. There are no revenue code limitations.

Recovery Support Navigator (RSN)

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

ED-Based	Med/Surg
Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff. There are no revenue code limitations. For hospitals billing for the ED crisis eval, claims should be submitted to the plan using H2015-HF on the UB 04 claim. There are no revenue code limitations.	Claims should be submitted to HNE if service was performed by the hospital staff or subcontracted BH staff. There are no revenue code limitations. Claims should be submitted to the plan using H2015-HF on the UB 04 claim. There are no revenue code limitations. S9485 is paid the MassHealth per diem rate

Date published:	April 30, 2024