101 CMR 315.01
General Provisions
(1) Scope. 101 CMR 315.00 governs the rates of payment used by governmental units and
purchasers under M.G.L. c. 152, § 1 et seq. (the Workers’ Compensation Act) for vision care
services and ophthalmic materials provided to publicly aided and industrial accident patients.
(2) Applicable Dates of Service. Rates contained in 101 CMR 315.00 are effective for dates of
service on or after February 14, 2025.
(3) Disclaimer of Authorization of Services. 101 CMR 315.00 is not authorization for or approval
of the procedures for which rates are determined pursuant to 101 CMR 315.00. Governmental
units that purchase care are responsible for the definition, authorization, and approval of care and
services provided to publicly aided clients.
(4) Administrative Bulletins. EOHHS may issue administrative bulletins to clarify provisions of
101 CMR 315.00, or to issue coding updates and corrections under 101 CMR 315.01(5).
(5) Coding Updates and Corrections. EOHHS may publish service code updates and corrections in
the form of administrative bulletin. Updates may reference coding systems including, but not limited
to, the American Medical Association’s Current Procedural Terminology (CPT) and the Healthcare
Common Procedure Coding System (HCPCS). The publication of such updates and corrections will
list
(a) codes for which the code numbers change, with the corresponding cross references between
the new codes and the codes being replaced. Rates for such updated codes are set at the rate of
the code that is being replaced;
(b) codes for which the code numbers remain the same but the description has changed;
(c) deleted codes for which there are no corresponding new codes; and
(d) codes for entirely new services that require pricing. EOHHS will list these codes and apply
individual consideration (IC) payment for these codes until appropriate rates can be developed.