Nonreimbursable Services

(A) The cost of any treatment or testing provided outside the hospital is allowed for in the rate- determination process and is not separately reimbursable. (B) All administrative and processing costs associated with the provision of blood and its derivatives are allowed for in the rate-determination process and are not separately reimbursable. MassHealth Subchapter Number and Title 4. Program Regulations Page Chronic Disease and Rehabilitation Inpatient Hospital Manual Transmittal Letter Date (C) Private hospital rooms are not reimbursable except where medically necessary. Payment for medically necessary private hospital rooms is included in the rates of payment set forth under 130 CMR 435.405(A). (D) Research and the provision of experimental procedures are not reimbursable. (E) Leave-of-absence days taken by a member are not reimbursable. For billing purposes, leave-of- absence days are to be treated in the same way as discharge and admission days. Thus, the day on which the member leaves the chronic-disease or rehabilitation hospital to start a leave of absence is not reimbursable, regardless of the hour of discharge, while the day on which the member returns is reimbursable. (F) Rest-home (level IV) services are not reimbursable. (G) The first 45 administrative days of a member’s admission or continued stay are not reimbursable.