DME and Supplies DME and Supplies Transportation Transportation All Other Services Crossover Claims: Rate Development MassHealth Base Data Category of Service Detailed Category of Service Inpatient Non-MH/SA IP Non-Behavioral Health – – Inpatient MH/SA IP - Mental Health IP Substance Abuse – Hospital Outpatient HOP ER / Urgent Care – HOP - Lab / Rad HOP Other – HOP Pharmacy – HOP PT/OT/ST – Outpatient MH/SA HOP - Behavioral Health Prof Behavioral Health – Professional Prof HIP Visits – Prof Lab / Rad – Prof OP Visits – Prof – HCBS/Home Health Home Health SNF LTC Facility Hospice DME and Supplies DME and Supplies Transportation Transportation Counties and Regions: will be paid on a Massachusetts county and MassHealth rating category basis. Rates, however, have been developed regionally. Five counties are not included in any of the One Care plan service areas: Barnstable. Bristol. Berkshire. Dukes. Nantucket. As the Demonstration does not currently operate in counties, any applicable claims and eligibility data for these counties has been removed from the base data. The resulting geographic classifications are as follows: Eastern: Essex, Middlesex, Norfolk and Suffolk counties Western: Franklin, Hampden, Hampshire and Worcester counties The Cape: Plymouth county
DME and Supplies DME and Supplies Transportation Transportation All Other Services Crossover Claims: Rate Development Category of Service MassHealth Base Data Detailed Category of Service Inpatient – Non-MH/SA IP – Non-Behavioral Health Inpatient MH/SA IP - Mental Health IP – Substance Abuse Hospital Outpatient HOP – ER / Urgent Care HOP - Lab / Rad HOP – Other HOP – Pharmacy HOP – PT/OT/ST Outpatient MH/SA HOP - Behavioral Health Prof – Behavioral Health Professional Prof – HIP Visits Prof – Lab / Rad Prof – OP Visits Prof – HCBS/Home Health Home Health LTC Facility SNF Hospice DME and Supplies DME and Supplies Transportation Transportation Counties and Regions: will be paid on a Massachusetts county and MassHealth rating category basis. Rates, however, have been developed regionally. Five counties are not included in any of the One Care plan service areas: Barnstable. Bristol. Berkshire. Dukes. Nantucket. As the Demonstration does not currently operate in counties, any applicable claims and eligibility data for these counties has been removed from the base data. The resulting geographic classifications are as follows: Eastern: Essex, Middlesex, Norfolk and Suffolk counties Western: Franklin, Hampden, Hampshire and Worcester counties The Cape: Plymouth county