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FY2022 General Appropriations Act- Home Health Aide Retro Claims Adjustment

November 15, 2021

MassHealth has completed updates to the agency’s claims system to allow home health agencies to bill and be reimbursed for the rates established under 101 CMR 449.00 Rates for Certain Home- and Community-Based Services Related to Workforce Development (Link: https://tinyurl.com/d5brpwrd). Rates established under 101 CMR 449.000 have been promulgated via emergency rate process effective October 1, 2021 through June 30, 2022.

MassHealth will be adjusting all submitted home health aide provider claims for dates of service between October 1, 2021 and November 26, 2021 to account for the increased rates. Home health agencies will not need to resubmit claims or request claims adjustments from the MassHealth agency for any claims submitted without the supplemental add-on rate for dates of service prior to November 26. After November 26, home health agencies are expected to bill for home health services using the higher rates established under 101 CMR 449.00.

Providers who have submitted a span bill for dates of service starting before October 1, 2021 which includes dates during the retro adjustment period must reach out to the LTSS Service Center for support. It is not recommended to use span billing during this time.

If you or your agency has questions regarding this guidance, please contact the LTSS Provider Service Center at (844) 368-5184 or support@masshealthltss.com.