MedicaidBilling CodesMedium impact
Managed Care Entity Bulletin 140: Updates to T1015-TH Modifier Use
MassHealth·MA · OB-GYN·Managed Care
Effective date
Nov 1, 2025
We identified it
Jun 18, 2026
Summary
Effective November 1, 2025, all community health center visits billed with CPT code T1015 for services by certified nurse midwives or obstetrician gynecologists must include the TH modifier, regardless of whether the service is prenatal/postpartum related. This updates previous guidance and applies to all MassHealth managed care entities.
Action Required
By November 1, 2025: Billing team must update system to automatically append TH modifier to all T1015 codes when billed by community health centers for certified nurse midwife or obstetrician gynecologist services. Update billing software rules and encounter forms to ensure TH modifier is included for all T1015 visits regardless of service type. Medical records may be reviewed for compliance.