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MassHealthMedicaid · Reimbursement · Managed Care · MA · PsychiatryMedium impact

Managed Care Entity Bulletin 142: Youth Withdrawal Management within Inpatient Psychiatric Unit

Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 18, 2026

Summary

MassHealth has updated the directed minimum rate floor for Youth Withdrawal Management and Stabilization Services (HCPCS H0011-HV) provided within inpatient psychiatric units to $1,208.58 per diem, effective January 1, 2026. This applies to ACPPs, MCOs, and the MassHealth behavioral health vendor serving adolescents ages 13-17.

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What to do

by Jan 1, 2026 · 2 steps
01Billing team must update contracted rates with MassHealth ACPPs, MCOs, and behavioral health vendor to ensure reimbursement for HCPCS H0011-HV (Youth Withdrawal Management) meets the new minimum rate floor of $1,208.58 per diem.
02Review existing contracts and negotiate rate adjustments if current rates fall below this threshold.

Codes mentioned

H0011

Original notice

Managed Care Entity Bulletin 142: Youth Withdrawal Management within Inpatient Psychiatric Unit
mass.gov · Always check the source before changing claims.
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Related policy hubs

MassHealth policiesMA policy changesPsychiatryCode H0011

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