MassHealth has issued MassHealth Nursing Facility Bulletin 191, Additional member specific criterion required to bill for the Substance Use Disorder (SUD) Add-on. The Bulletin clarifies that for a nursing facility to bill for the SUD $50 per day member specific add-on, eligible nursing facilities must ensure that the member receives at least one of the following services during the same billing month as the dates of service billed for the SUD add-on:
- Opioid use disorder counseling, in individual or group format;
- Medication management for medications for opioid use disorder treatment;
- Other SUD-related counseling, in individual or group format; or
- Medication management for medications for other SUD treatment.
With respect to medication management services, the Bulletin clarifies that this service must align with the Department of Public Health (DPH)’s Memorandum for Admission of Residents on Medication for Opioid Use Disorder to Long-Term Care Facilities, dated September 12, 2022.