Payment Limitations: Duration and Frequency

(A) Home Visit. Payment for a home visit is limited to two hours per visit. Payment will be made for no more than two home visits on a single day. (B) Center-Based Individual Visit. Payment for a center-based individual visit is limited to two hours per visit. (C) Child-Focused Group Session. Payment for a child-focused group session is limited to two and one-half hours per session. (D) Parent-Focused Group Session. Payment for a parent-focused group session is limited to two hours per session and one session per week. (E) Services Provided on the Same Day. The Division does not pay for more than one visit or session with the same service code provided to the same member on the same day with the exception of the home visit limitation as noted in 130 CMR 440.421(A). (F) Evaluation/Assessment. An evaluation must be conducted upon the member’s enrollment in the program and then annually to determine continued eligibility. An assessment may be conducted periodically to determine the child’s strengths and needs. Payment is limited to 10 working hours per 12-month period for evaluation/assessment. (G) Intake/Screening. Payment for a screening is limited to two working hours.