General Provisions

(1) Scope and Purpose. 101 CMR 444.00 governs rates of payment for opioid treatment and other substance use disorder services to be used by all governmental units making payment to eligible providers of certain substance use disorder services to publicly assisted clients. The rates for health care services set forth in 101 CMR 444.00 also apply to individuals covered by M.G.L. c.152 (the Workers' Compensation Act). (2) Applicable Dates of Service. Rates contained in 101 CMR 444.00 apply for dates of service provided on or after March 28, 2025. (3) Disclaimer of Authorization of Services. 101 CMR 444.00 is neither authorization for nor approval of the substantive services for which rates are determined pursuant to 101 CMR 444.00. Governmental units that purchase services from eligible providers are responsible for the definition, authorization, and approval of services extended to publicly assisted clients. (4) Coding Updates and Corrections. EOHHS may publish procedure code updates and corrections in the form of an administrative bulletin. The publication of such updates and corrections will list: (a) codes for which only the code numbers change, with the corresponding cross references between existing and new codes; (b) deleted codes for which there are no corresponding new codes; and (c) codes for entirely new services that require pricing. EOHHS will list these codes and apply individual consideration (IC) reimbursement for these codes until appropriate rates can be developed.