Approved State Directed Payment Preprints

Uniform dollar increase established by the state for primary care services and pediatric nursing facility services for the rating period, October 1, 2023, through September 30,2024, incorporated into the capitation rates through a separate payment term of up to $15million.

Uniform dollar increase established by the state for the professional services at academic medical centers for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to$103,203,351.

Minimum fee schedule established by the state for laboratory services provided by in-state acute care hospitals and critical access hospitals for the rating period covering July1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based adjustment.

Minimum fee schedule established by the state for public ambulance provider services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based adjustment.

Uniform dollar increase established by the state for local health department services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $79,100,000.

Maximum Fee Schedule for MassHealth contracted acute hospitals (except for specialty cancer hospitals, freestanding pediatric hospitals for an inpatient discharge with a MassHealth DRG Weight of 3 or greater, and the acute hospital with a pediatric specialty unit for enrollees under the age of 21 at the time of admission for an inpatient discharge with a MassHealth DRG Weight of 3 or greater) for the rating period covering April 1,2023 through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.

Minimum Fee Schedule and Maximum Fee Schedule for inpatient hospital discharges from freestanding pediatric hospitals with a MassHealth DRG weight of 3.0 or greater and hospitals with a pediatric specialty unit with a MassHealth DRG weight of 3.0 or greater, using an approved State plan fee schedule for the rating period covering April 1,2023 – December 31, 2023.

Minimum fee scheduled established by the State for outpatient behavioral health services and behavioral health diversionary services for the rating period covering April 1, 2023through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.

Uniform increase established by the state for certain Home Health Aide, Homemaker, and Personal Care providers (excepting Personal Care providers providing services through the self-directed Personal Care Attendant Program) for the rating period covering January 1, 2023 through December 31, 2023.

Uniform increase for eligible professional services at designated academic medical centers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term up to $49,140,684.01.