CSN Retention Bonus Program for Home Health Agency Nurses
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Defines a retention bonus program for licensed nurses providing continuous skilled nursing (CSN) services through MassHealth-enrolled home health agencies (HHAs), including eligibility, bonus amounts, billing codes, documentation, and payment schedule for dates of service April 2023 through June 2024.
This bulletin supersedes and replaces Home Health Agency Bulletin 82 and extends program dates of service to April 2023 through June 2024.
CSN Retention Bonus — Eligibility & Rules
CSN retention bonus coverage criteria and billing rules
Covered when ALL of the following conditions are met:
ALL of the following
- Nurse must be a licensed nurse employed by a MassHealth-enrolled home health agency (HHA) and provide continuous skilled nursing (CSN) services directly to MassHealth members enrolled in the Community Case Management (CCM) program.
Also countable toward service commitment
- CSN services provided to MassHealth members enrolled in OneCare or Senior Care Options or MassHealth’s Special Kids Special Care Program.
- CSN services provided to CCM members that are included in their individualized education programs.
- CSN hours provided to CCM members and reimbursed by a commercial health insurance plan.
ALL of the following
ONE of the following must be met
- 480 hours of CSN services in a 3-month service quarter — Retention bonus = $3,250.
- 360 hours of CSN services in a 3-month service quarter — Retention bonus = $2,000.
- 260 hours of CSN services in a 3-month service quarter — Retention bonus = $1,200.
ALL of the following
- A nurse is eligible for only one retention bonus per service quarter; hours cannot be combined across multiple agencies or between independent and agency work to meet a threshold.
ALL of the following
ALL of the following
- HHAs must submit retention bonus claims to MassHealth each service quarter during the calendar month immediately after the quarter ends (billing months specified for April 2023–June 2024).
- Each claim submission must be attached to a CCM member whom the qualifying CSN nurse served, and must include a completed Retention Bonus Claim Attachment Form specific to the qualifying nurse and dates of service. Claims submitted without the completed attachment will be denied.
ALL of the following
- HHAs will receive payment each quarter and must forward the full retention bonus amount to the qualifying nurse as soon as reasonably possible; noncash payments (credit, gift certificate, etc.) are not reimbursable.
- HHAs must maintain records demonstrating each qualifying nurse met the service commitment and that the full bonus was paid to the nurse.
ALL of the following
- Agencies that fail to adhere to bulletin requirements, including improper payments or failure to pay the full bonus to nurses, may be subject to sanctions or overpayment provisions under 130 CMR (e.g., 450.238, 450.235).
Billing Codes, Service Commitments, and Bonus Amounts
Billing & Submission Requirements
Quarterly claim submission must include completed Retention Bonus Claim Attachment
HHAs must submit retention bonus claims each service quarter during the calendar month immediately after the previous quarter ends. Each claim submission must include a completed “Retention Bonus Claim Attachment Form for Continuous Skilled Nursing” that is specific to the qualifying CSN nurse and the dates of service; the attachment must be completed in its entirety and claims submitted without the attachment will be automatically denied.
- Attach the Retention Bonus Claim Attachment Form for Continuous Skilled Nursing to each claim.
- Ensure the attachment is specific to the qualifying CSN nurse and the dates of service billed.
- Claims without the completed attachment will be automatically denied.
Program Definitions & Service Requirements
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