101 Mass. Reg. 361.04

Current through Register 1520, April 26, 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		$17.83	$14.65	RN Services, Weekday
T1002	UJ	$18.94	$15.66	RN Services, Nights
T1002		$24.66	$20.99	RN Services, Holidays
T1003		$14.71	$12.20	LPN Services, Weekday
T1003	UJ	$15.63	$13.07	LPN Services, Nights
T1003		$20.46	$17.58	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 % 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	$25.08	$21.18	RN Services, Weekday
T1002	U1	$26.71	$22.72	RN Services, Nights
T1002	TT	$35.29	$30.68	RN Services, Holidays
T1003	TT	$20.79	$17.71	LPN Services, Weekday
T1003	U1	$22.17	$19.00	LPN Services, Nights
T1003	TT	$29.43	$25.75	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 ²/₃ 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	$29.96	$24.56	RN Services, Weekday
T1002	U3	$31.88	$26.35	RN Services, Nights
T1002	U2	$41.90	$35.65	RN Services, Holidays
T1003	U2	$25.23	$20.54	LPN Services, Weekday
T1003	U3	$26.85	$22.06	LPN Services, Nights
T1003	U2	$35.32	$29.92	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	$24.66	$20.99	RN Services, Weekday
T1002	U4	$26.31	$22.52	RN Services, Nights
T1002	TU	$34.89	$30.49	RN Services, Holidays
T1003	TU	$20.46	$17.58	LPN Services, Weekday
T1003	U4	$21.86	$18.87	LPN Services, Nights
T1003	TU	$29.11	$25.60	LPN Services, Holidays

(2)Complex Care Assistant and RN Supervisory Visits.

Rate per 15 Minutes: Complex Care Assistant and RN Supervisory Visits
Code	Modifier	Agency	Description
T1002	U5	$17.83	60-day Supervisory Visit (RN)
T1004		$11.25	Complex Care Assistant Visit