MassHealth has identified an issue that resulted in payments for the claims that were incorrectly billed to the MassHealth Fee-For-Service program despite member enrollment in the Massachusetts Behavioral Health Partnership (MBHP). This includes S9485 claims for behavioral health crisis evaluations and S9485 claims with modifier V1 or V2 for behavioral health crisis management services. This reprocess applies to relevant claims with service dates between January 2023 and August 2024.
An email was sent to affected hospitals on December 13, 2024, with the specifics of the reprocessing details, including the total dollars that will be recouped, for that particular hospital.
If you have questions regarding this message, please contact MassHealth at provider@masshealthquestions.com or (800) 841-2900.