An Act relative to access to psychiatric collaborative care
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9 section(s) · formatted for easier reading
▸SECTION 1
Section 22A of chapter 32A of the General Laws, as appearing in the 2024 Official Edition, is hereby amended by inserting after subsection (b) the following subsection:-
(c) The commission shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
▸SECTION 2
Section 10P of chapter 118E of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) The division shall, subject to federal approval of the Massachusetts Medicaid State Plan and the availability of federal financial participation, ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted in accordance with section 13D, if applicable.
▸SECTION 3
Section 47QQ of chapter 175 of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) An individual policy of accident and sickness insurance issued pursuant to section 108 that provides hospital expense and surgical expense insurance or a group blanket or general policy of accident and sickness insurance issued pursuant to section 110 that provides hospital expense and surgical expense insurance that is issued or renewed within or without the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
▸SECTION 4
Section 8RR of chapter 176A of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) A contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
▸SECTION 5
Section 4RR of chapter 176B of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) A subscription certificate under an individual or group medical service agreement that is issued or renewed within the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
▸SECTION 6
Section 4JJ of chapter 176G of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) Any individual or group health maintenance contract that is issued or renewed within the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
▸SECTION 7
Chapter 177 of the acts of 2022 is hereby amended by striking out section 84 and inserting in place thereof the following section:-
▸SECTION 84
For the purposes of section 22A of chapter 32A of the General Laws, section 10P of chapter 118E of the General Laws, section 47QQ of chapter 175 of the General Laws, section 8RR of chapter 176A of the General Laws, section 4RR of chapter 176B of the General Laws and section 4JJ of chapter 176G of the General Laws, reimbursement for the psychiatric collaborative care model shall include, but shall not be limited to, the following current procedural terminology billing codes: (i) 99492; (ii) 99493; (iii) 99494; and (iv) G2214; provided, that the division of insurance may promulgate regulations or issue further guidance establishing additional psychiatric collaborative care model billing codes and minimum payment rates for such codes.
▸SECTION 8
Subsection (c) of section 22A of chapter 32A of the General Laws, subsection (c) of section 10P of chapter 118E of the General Laws, subsection (c) of section 47QQ of chapter 175 of the General Laws, subsection (c) of section 8RR of chapter 176A of the General Laws, subsection (c) of section 4RR of chapter 176B of the General Laws and subsection (c) of section 4JJ of chapter 176G of the General Laws shall apply to all contracts entered into, renewed or amended on or after January 1, 2027.
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SECTION 1. Section 22A of chapter 32A of the General Laws, as appearing in the 2024 Official Edition, is hereby amended by inserting after subsection (b) the following subsection:-
(c) The commission shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
SECTION 2. Section 10P of chapter 118E of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) The division shall, subject to federal approval of the Massachusetts Medicaid State Plan and the availability of federal financial participation, ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted in accordance with section 13D, if applicable.
SECTION 3. Section 47QQ of chapter 175 of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) An individual policy of accident and sickness insurance issued pursuant to section 108 that provides hospital expense and surgical expense insurance or a group blanket or general policy of accident and sickness insurance issued pursuant to section 110 that provides hospital expense and surgical expense insurance that is issued or renewed within or without the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
SECTION 4. Section 8RR of chapter 176A of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) A contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
SECTION 5. Section 4RR of chapter 176B of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) A subscription certificate under an individual or group medical service agreement that is issued or renewed within the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
SECTION 6. Section 4JJ of chapter 176G of the General Laws, as so appearing, is hereby amended by inserting after subsection (b) the following subsection:-
(c) Any individual or group health maintenance contract that is issued or renewed within the commonwealth shall ensure minimum payment rates for psychiatric collaborative care model billing codes are equal to or greater than the current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted annually, if applicable.
SECTION 7. Chapter 177 of the acts of 2022 is hereby amended by striking out section 84 and inserting in place thereof the following section:-
Section 84. For the purposes of section 22A of chapter 32A of the General Laws, section 10P of chapter 118E of the General Laws, section 47QQ of chapter 175 of the General Laws, section 8RR of chapter 176A of the General Laws, section 4RR of chapter 176B of the General Laws and section 4JJ of chapter 176G of the General Laws, reimbursement for the psychiatric collaborative care model shall include, but shall not be limited to, the following current procedural terminology billing codes: (i) 99492; (ii) 99493; (iii) 99494; and (iv) G2214; provided, that the division of insurance may promulgate regulations or issue further guidance establishing additional psychiatric collaborative care model billing codes and minimum payment rates for such codes.
SECTION 8. Subsection (c) of section 22A of chapter 32A of the General Laws, subsection (c) of section 10P of chapter 118E of the General Laws, subsection (c) of section 47QQ of chapter 175 of the General Laws, subsection (c) of section 8RR of chapter 176A of the General Laws, subsection (c) of section 4RR of chapter 176B of the General Laws and subsection (c) of section 4JJ of chapter 176G of the General Laws shall apply to all contracts entered into, renewed or amended on or after January 1, 2027.