Obstetric Services: Fee-for-service Method of Payment

The fee-for-service method of payment is always available to a provider for obstetric services covered by MassHealth. If the global fee requirements in 130 CMR 405.423 are not met, the provider or providers may claim payment from the MassHealth agency only on a fee-for-service basis, as specified in 130 CM 405.426(A) and (B). (A) If the pregnancy is terminated by an event other than a delivery, each provider involved in performing obstetric services for the member may claim payment only on a fee-for-service basis. (B) When additional services (for example, ultrasound or special tests) are performed, the provider may claim payment for these only on a fee-for-service basis.