Home Health Agency Bulletin 83 — COVID-19 Flexibilities after the End of the Public Health Emergency
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Sets which COVID-19–related flexibilities for MassHealth home health agencies end or continue after the federal Public Health Emergency ended on May 11, 2023, and specifies requirements for telehealth, documentation, prior authorization, and aide supervision for MassHealth-covered home health services.
This bulletin replaces prior FPHE-related bulletins 63 and 64 and takes effect May 12, 2023.
MassHealth will end the flexibility allowing providers to extend a prior authorization by written request after the FPHE.
MassHealth will end the flexibility allowing services when an available caregiver is unable to serve due to COVID-19 after the FPHE.
MassHealth will end the temporary waiver of home health aide supervision requirements after the FPHE.
MassHealth ends the flexibility for the 12-hour annual in-service training requirement after an extension period to the first full quarter post-FPHE.
Telehealth allowances for face-to-face encounters and home health services continue with limits through December 31, 2024.
Specific telehealth billing, modifiers, and documentation requirements are specified for home health services.
Providers must obtain and document verbal member consent prior to telehealth home health services, including required disclosures.
Plans of care signature flexibility continues until regulations are updated; providers must obtain a signed plan before first claim or within 90 days of first claim.
Coverage for Home Health Telehealth & Post-FPHE Flexibilities
Coverage criteria for home health services delivered via telehealth and FPHE flexibilities
MassHealth will continue to cover certain home health services delivered via telehealth provided they are medically necessary and clinically appropriate under the conditions below.
Allowed visit types
- Follow-up visits that do not require any hands-on care.
- Ongoing review of the member’s assessment, including 60-day recertification for home health services.
- Discharge visits.
- Follow-up visits may be conducted by telephone if appropriate, though live video is preferred.
Prohibited visit types
- Any service that requires hands-on care.
- Any start-of-care (SOC) assessment visit.
- Any resumption-of-care visit.
Billing Modifiers and Coding for Telehealth Home Health
| GT | Modifier required on claims for services delivered via telehealth |
Provider Requirements and Prior Authorization
Prior authorization and PA requirements
Following the end of the federal Public Health Emergency (FPHE), the temporary flexibility allowing providers to extend a prior authorization (PA) by submitting a written request to MassHealth has ended. Providers must follow all prior authorization requirements under 130 CMR 403.410 and the regulatory PA requirements at 130 CMR 403.000 when requesting authorizations for home health services.
- Do not submit written-extension requests to extend an existing PA—these extensions are no longer permitted.
- Submit PA requests in accordance with 130 CMR 403.410 and the broader PA regulations at 130 CMR 403.000.
Key Definitions: Telehealth and Consent
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