101 CMR, § 361.04

Current through Register 1536, December 6, 2024

Section 361.04 - Rates of Payment

(1)Continuous Skilled Nursing Services.

(a)Single Patient, per Straight-time Hour. Weekend rates are the same as night rates.

Rates per 15 Minutes: Single Patient, per Straight-time Hour
Code	Modifier	Agency	Individual Practitioner	Description
T1002		$23.61	$19.46	RN Services, Weekday
T1002	UJ	$25.14	$20.88	RN Services, Nights
T1002		$33.12	$28.22	RN Services, Holidays
T1003		$16.35	$13.47	LPN Services, Weekday
T1003	UJ	$17.41	$14.46	LPN Services, Nights
T1003		$23.01	$19.60	LPN Services, Holidays

(b)Multiple-patient Nursing.

(1)Two Individuals, per Straight-time Hour. When only one of the individuals is publicly aided, the fee for services to the publicly aided individual will be U of the appropriate rate listed in the table "Two Individuals, per Straight-time Hour." Weekend rates are the same as night rates.

Rates per 15 Minutes: Two Individuals, per Straight-time Hour
Code	Modifier	Agency	Individual Practitioner	Description
T1002	TT	$33.21	$28.13	RN Services, Weekday
T1002	U1	$35.36	$30.18	RN Services, Nights
T1002	TT	$46.59	$40.80	RN Services, Holidays
T1003	TT	$23.10	$19.56	LPN Services, Weekday
T1003	U1	$24.61	$20.99	LPN Services, Nights
T1003	TT	$32.52	$28.46	LPN Services, Holidays

2.Three Individuals, per Straight-time Hour. When only one of the individuals is publicly aided, the fee for services to the publicly aided individual will be a of the appropriate rate listed. When two of the individuals are publicly aided, the fee for services to the publicly aided individuals will be % of the appropriate rate listed. Weekend rates are the same as night rates.

Rates per 15 Minutes: Three Individuals, per Straight-time Hour
Code	Modifier	Agency	Individual Practitioner	Description
T1002	U2	$39.68	$32.62	RN Services, Weekday
T1002	U3	$42.24	$35.00	RN Services, Nights
T1002	U2	$55.66	$47.31	RN Services, Holidays
T1003	U2	$28.04	$22.68	LPN Services, Weekday
T1003	U3	$29.87	$24.34	LPN Services, Nights
T1003	U2	$39.47	$33.00	LPN Services, Holidays

(c)Overtime. Weekend rates are the same as night rates.

Rates per 15 Minutes: Overtime
Code	Modifier	Agency	Individual Practitioner	Description
T1002	TU	$32.66	$27.88	RN Services, Weekday
T1002	U4	$34.77	$29.91	RN Services, Nights
T1002	TU	$48.77	$40.43	RN Services, Holidays
T1003	TU	$22.74	$19.41	LPN Services, Weekday
T1003	U4	$24.22	$20.83	LPN Services, Nights
T1003	TU	$32.01	$28.25	LPN Services, Holidays

(d)Complex Care Assistant and RN Supervisory Visits.

Rate per 15 Minutes: Complex Care Assistant and RN Supervisory Visits
Code	Modifier	Agency	Description
T1002	U5	$23.61	60-day Supervisory Visit (RN)
T1004		$11.25	Complex Care Assistant Visit