ALL of the following

• Service-hour thresholds

  • Nurse completed 480 CSN service hours during the designated service quarter; retention bonus amount = $3,250.
  • Nurse completed 360 CSN service hours during the designated service quarter; retention bonus amount = $2,000.
  • Nurse completed 260 CSN service hours during the designated service quarter; retention bonus amount = $1,200.

ALL of the following

• Counted hours must be CSN services provided directly to MassHealth members enrolled in the Community Case Management (CCM) program.

• Additional acceptable counted hours

  • CSN services provided to MassHealth members enrolled in OneCare or Senior Care Options (SCO).
  • CSN services provided to CCM members that are included in their individualized education programs (IEPs).
  • CSN hours provided to CCM members that are reimbursed by a commercial healthcare insurance plan.

ALL of the following

• Each claim must be attached to a CCM member whom the qualifying CSN nurse has 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 automatically denied.

ALL of the following

• Agencies must bill using the designated procedure codes: T1030 U1 (480 hours), T1030 U2 (360 hours), or T1030 U3 (260 hours) — per nurse.
• Each unit billed will include a 10% rate add-on above the retention bonus amounts to offset agency administrative costs.

ALL of the following

• Agencies must retain records that demonstrate each qualifying nurse met the service commitment requirements and that the full retention bonus amount was paid directly to the qualifying nurse (payments by credit, gift certificate, etc., are not reimbursable).
• Failure to adhere to bulletin requirements may result in sanctions or overpayment recovery in accordance with 130 CMR 450.238 and 130 CMR 450.235.