Skilled Nursing

(A) Conditions of Payment. Skilled nursing services listed in a participant’s service plan must be provided within the scope of the State’s Nurse Practice Act at M.G.L. c. 112 and regulations at 244 CMR 3.00: Registered Nurse and Licensed Practical Nurse. (B) Nonpayable Services. (1) Skilled Nursing services are limited to one skilled nursing visit per week per participant. The MassHealth agency or its designee may authorize an exception to the limit on a temporary basis to facilitate transitions to a community setting, to ensure that a participant at risk for medical facility admission is able to remain in the community, or to otherwise stabilize a participant’s medical condition. (2) Skilled nursing services are not covered when duplicative nursing services are provided to the participant.