Behavioral Health Services

(A) Behavioral Health Contractor. Except as provided in 130 CMR 450.124(B) and (C), all behavioral health services covered by the MassHealth agency’s contract with the behavioral health contractor (the Contractor) are authorized, provided, and paid solely by the Contractor. Payment for such services is subject to the terms of the Contractor's provider contracts including, but not limited to, provisions governing service authorization, performance specifications, and billing requirements. Any provider seeking a contract with the Contractor should contact the Contractor directly. 1. Introduction (130 CMR 450.000) (B) Emergency Services. Members may obtain emergency behavioral health services from any qualified participating MassHealth provider as well as any provider that has entered into an agreement with the Contractor. Providers should refer to MassHealth bulletins for information and guidance on submission of claims for emergency department behavioral health visits. (C) Services to Exempt Members. Services provided to the following MassHealth members are not subject to 130 CMR 450.124: (1) members who are enrolled in an MCO, Accountable Care Partnership Plan, One Care Plan, or SCO Plan; and (2) members who are excluded from participating in managed care under 130 CMR 508.002: MassHealth Members Excluded from Participation in Managed Care unless such member is enrolled with the behavioral health contractor pursuant to 130 CMR 508.001(E). (130 CMR 450.125 through 450.129 Reserved) 1. Introduction (130 CMR 450.000)