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Health Care Training Forum

New Billing Instructions for Adult Day Health (ADH) Providers

June 18, 2018

Effective 06/11/2018 ADH providers must restrict billing for ADH service codes S5100, S5100 TG and S5100 U1 to 24 units (6 hours) per day. If an ADH provider bills in excess of 24 units (6 hours) per day, claims will deny for Edit 8164 - ADULT DAY HEALTH CODE S5100 LIMIT 6 HRS PER DAY.  

Please note that one unit equals 15 minutes.

Please remember to bill daily for no more than 24 units. Billing from and through dates of service is no longer allowed.

If you have any questions regarding this change, please contact the MassHealth LTSS Service Center at 1-844-368-5184 or email support@masshealthltss.com.