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Changes to Repetitive Transcranial Magnetic Stimulation (rTMS)

December 26, 2018

Effective January 1, 2019, the Massachusetts Behavioral Health Partnership (MBHP) will cover Repetitive Transcranial Magnetic Stimulation (rTMS) for MassHealth members who receive their behavioral health benefits through MBHP. This applies to all members enrolled in MBHP, including those also enrolled with Community Care Cooperative (C3), Partners Healthcare Choice, Steward Health Choice plans, and the Primary Care Clinician (PCC) Plan. 

rTMS is a noninvasive method of brain stimulation using Magnetic Resonance Imaging (MRI)-strength magnetic field pulses. This procedure is a U.S. Food and Drug Administration (FDA) approved method for the treatment of resistant major depression.

The codes associated with rTMS are 90867, 90868, and 90869. For dates of service after 01/01/19, claims with these codes should be submitted to MBHP instead of MassHealth for members enrolled in MBHP. The error message associated with incorrectly submitted claims to MassHealth will be: 2614 (MNG-CARE SERV SHOULD BE PAID BY MASSHLTH BHVL HLTH).

If you have questions about submitting claims to MBHP, please contact MBHP's Community Relations Department at 1-800-495-0086 (press 1 for the English menu or 2 for the Spanish menu, then 3 then 1 to skip prompts), Monday through Thursday from 8:00 a.m. to 5:00 p.m., and on Fridays from 9:30 a.m. to 5:00 p.m.