Nonreimbursable Services

(A) Research and Experimental Treatment. The MassHealth agency does not pay for research or experimental treatment. (B) Travel Time for Outreach. Travel time to and from an outreach visit, including a member's home, place of residence, or an appropriate, mutually agreed-upon community-based location, is not a reimbursable service. (C) Nonmedical Programs. The MassHealth agency does not pay for diagnostic and treatment services that are provided as an integral part of a planned and comprehensive program that is organized to provide primarily nonmedical or other nonreimbursable services. Such programs include residential programs, day activity programs, drop-in centers, and educational programs. (D) Referrals. A provider to whom a member is referred must bill the MassHealth agency directly for any services rendered as a result of the referral, not through the PACT provider. To receive payment for referral services, the rendering provider must be a participating provider in MassHealth on the date of service.