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Uninsured (with no MassHealth Limited coverage)

Acute care billing instructions for behavioral health services provided to members that are Uninsured (with no MassHealth Limited coverage).

Table of Contents

BH Crisis Evaluation (Required of Hospitals)

On initial day of readiness (S9485, no modifier)

ED-Based

Med/Surg

Hospital providers should bill MBHP under the uninsured group number. Hospitals do not need contract with MBHP to bill for uninsured patients.

Hospital providers should bill MBHP under the uninsured group number. Hospitals do not need contract with MBHP to bill for uninsured patients.

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

Hospital providers should bill under Health Safety Net

Hospital providers should bill under Health Safety Net

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

Not currently a service eligible for payment

 

Recovery Support Navigator (RSN)

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

ED-Based

Med/Surg

Not currently a service eligible for payment

Not currently a service eligible for payment

Date published: April 30, 2024

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