Payment Rates

Except as to drugs designated by Pharmacy Facts, provider bulletin, or other written issuance from the MassHealth agency, the methods for determining payment of drugs are contained in 101 CMR 331.00: Prescribed Drugs. The methods for determining payment for medical supplies described in 130 CMR 406.412 are contained in 101 CMR 322.00: Rates for Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment and 101 CMR 317.00: Rates for Medicine Services. The methods for determining payment for services listed on the MassHealth Pharmacy Covered Professional Services List are contained in 101 CMR 317.00: Rates for Medicine Services. In the event of conflict between 130 CMR 406.000 and 101 CMR 331.00: Prescribed Drugs, 101 CMR 331.00: Prescribed Drugs will govern.