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NCCI/MUE 1st Quarter Updates Effective January 1,2020

December 30, 2019

Per CMS National Correct Coding Initiative (NCCI) Medically Unlikely Edits (MUEs), codes T1006 HR, T1006, and T1006 HD have changed from two units maximum per day to one unit maximum per day effective 1/1/2020. To accommodate changes to the maximum units, MassHealth has updated existing code modifiers to reflect the one unit maximum change, and has also added additional code modifiers for the corresponding CMS NCCI MUE changes.

Pursuant to these changes, providers may bill only one 30-minute or one 60-minute Substance Use Disorder Treatment (SUD) family/couple counseling service per member per day.

The updated modifiers are as follows: 

  • T1006 HD: Alcohol and/or drug services; family/couple counseling (pregnant/parenting women's program) (per 60-minute unit) (one unit maximum per day). 
  • T1006 TH: Alcohol and/or drug services; family/couple counseling (pregnant/parenting women's program) (one 60-minute unit max per day). 
  • T1006: Alcohol and/or substance abuse services; family/couple counseling (per 30-minute unit) (one unit maximum per day).
  • T1006 HF: Alcohol and/or substance abuse services; family/couple counseling (one 60-minute unit max per day).
  • T1006 HR: Alcohol and/or substance abuse services; family/couple counseling (family/couple with client present) (opioid family/couple counseling) (per 30-minute unit) (one unit maximum per day).
  • T1006 HG: Alcohol and/or substance abuse services; family/couple counseling (with client present) (opioid family/couples counseling) (one 60-minute unit max per day).

If you have any questions, please contact the MassHealth Customer Service Center at (800) 841-2900 or e-mail providersupport@mahealth.net.