№ files_lp_3_process_7_062159
Official reimbursement schedule issued by the Health Safety Net of the Commonwealth of Massachusetts listing billable CPT, HCPCS, and CDT procedure codes and corresponding payment methodologies and rates for community health centers effective January 1, 2025.
Year: 2025
Effective Date: January 1, 2025
Jurisdiction: Commonwealth of Massachusetts
Program: Health Safety Net
Issuing Authority: Health Safety Net
Regulatory References: 101 CMR 613.000; 101 CMR 614.000; 101 CMR 304.00; 101 CMR 315.00; 101 CMR 317.00; 101 CMR 312.00
Document Type: Reimbursable procedure code guide and payment rate schedule
Subject: Billable procedure codes and payment methodologies for community health centers
Applicable Providers: Community Health Center providers participating in Health Safety Net
Service Categories: Medical Visits; Urgent Care/After Hours; Home Health; Telephonic Services; Surgery; Vision Care; Vision Diagnostic Services; Vaccines, Drugs and Supplies; Behavioral Health; Physical Therapy; Laboratory; Radiology; Obstetrics and Gynecology; Dental; Preventative Medicine Counseling; Cardiology and Pulmonology
Payment Methodology: Prospective Payment System (PPS) and other specified methodologies
PPS Rates (Established Patient): $225.95 (Metro Boston); $210.35 (Rest of MA)
PPS Rates (New Patient/Wellness): $303.14 (Metro Boston); $282.21 (Rest of MA)
Geographic Areas: Metro Boston; Rest of Massachusetts
Price: 8 / 10 USD
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