Nonpayable Circumstances

The MassHealth agency does not pay a licensed independent behavioral health clinician for services provided under any of the following circumstances. (A) The licensed independent behavioral health clinician provided the service in a facility approved by the MassHealth agency and is paid by the facility to provide that service, whether or not the cost of the service is included in the MassHealth agency’s rate of payment for that facility. (B) The licensed independent behavioral health clinician provided the service in a facility that is organized to provide primarily nonmedical services and is paid by the facility to provide the service. (C) The licensed independent behavioral health clinician has received or will receive payment for the service from the Commonwealth, county, or municipality. (D) Under comparable circumstances, the licensed independent behavioral health clinician does not customarily bill patients who do not have health insurance.