Multiple-patient Care

(A) The MassHealth agency pays for one nurse to provide CSN services simultaneously to more than one member, but not more than three members, if (1) the members have been determined by the MassHealth agency or its designee to meet the criteria listed at 130 CMR 414.408; (2) the members receive services in the same household and during the same time period; (3) the MassHealth agency or its designee has determined that it is appropriate for one nurse to provide nursing services to the members simultaneously; and (4) the independent nurse has received a separate prior authorization from the MassHealth agency or its designee for each member as described in 130 CMR 414.413. (B) Services provided pursuant to 130 CMR 414.410(A) must be billed by using the multiple- patient service code and modifier that reflects the number of members receiving the services.