Continuous Skilled Nursing (CSN) Retention Bonus Program
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Defines a MassHealth retention bonus program for licensed nurses employed by MassHealth-enrolled Continuous Skilled Nursing (CSN) agencies, including bonus amounts, service commitment requirements, billing codes, documentation, and payment schedule for specified service quarters (April 2023–June 2024). Affects participating CSN agencies and their qualifying nurses.
This bulletin supersedes and replaces Continuous Skilled Nursing Agency Bulletin 11 and extends the dates of service for which the Retention Bonus program will be accessible to April 2023 through June 2024.
Retention Bonus Eligibility and Criteria
inv-01: Retention Bonus eligibility and billing criteria
A nurse is eligible for one retention bonus per service quarter when employed by a MassHealth‑enrolled CSN agency and meeting the service commitment requirements below. Agencies must document eligibility, submit required attachments with claims, and pass the full payment through to the qualifying nurse.
ALL of the following
Service hour thresholds (one applies)
- Provide at least 480 hours during the designated service quarter → Retention Bonus Amount = $3,250.
- Provide at least 360 hours during the designated service quarter → Retention Bonus Amount = $2,000.
- Provide at least 260 hours during the designated service quarter → Retention Bonus Amount = $1,200.
ALL of the following
- Countable services: Hours must be CSN services provided directly to MassHealth members enrolled in the Community Case Management (CCM) program.
Also count toward service commitment when applicable
- CSN services provided to MassHealth members enrolled in OneCare or Senior Care Options plans or MassHealth’s Special Kids Special Care Program.
- CSN services provided to CCM members that are included in their individualized education programs (IEPs).
- CSN hours provided to CCM members and reimbursed by a commercial healthcare insurance plan.
ALL of the following
- Billing timing: Agencies must submit retention bonus claims each service quarter during the calendar month immediately after the service quarter for which the bonus is sought.
- Attachment requirement: Each claim must include a completed Retention Bonus Claim Attachment Form specific to the qualifying CSN nurse and dates of service; claims submitted without the attachment will be automatically denied.
ALL of the following
ALL of the following
- Payment pass‑through and documentation: Agencies must pay the full retention bonus amount in cash to the qualifying nurse, maintain records demonstrating the nurse met the service commitment and that payment was made; credits, gift certificates, or similar are not reimbursable.
ALL of the following
- Compliance: Agencies must participate in quality management and program integrity processes requested by MassHealth and may be subject to sanctions or overpayment recoupment under 130 CMR 450.238 and 130 CMR 450.235 for noncompliance.
Procedure Codes, Modifiers, and Payment Details
| T1030 U1 | Nursing care, in the home, by registered nurse, per diem (CSN nurse retention bonus for 480 hours) (use for RN and LPN) (per nurse) |
| T1030 U2 | Nursing care, in the home, by registered nurse, per diem (CSN nurse retention bonus for 360 hours) (use for RN and LPN) (per nurse) |
| T1030 U3 | Nursing care, in the home, by registered nurse, per diem (CSN nurse retention bonus for 260 hours) (use for RN and LPN) (per nurse) |
Claims Submission and Documentation Requirements
Claim submission and attachment requirement
Submit the retention bonus claim for each service quarter during the calendar month immediately after the service quarter and include a completed Retention Bonus Claim Attachment Form specific to the qualifying nurse and the dates of service; claims submitted without the completed attachment will be denied. Each claim submission must be attached to a CCM member whom the qualifying CSN nurse has served, even if the nurse also qualifies by serving other CCM members.
- Submit claims each service quarter during the calendar month immediately after the quarter.
- Include a fully completed “Retention Bonus Claim Attachment Form for Continuous Skilled Nursing” specific to the nurse and dates of service.
- Attach the claim to a CCM member whom the qualifying CSN nurse served; claims without the attachment will be automatically denied.
Key Definitions
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