MedicaidBilling CodesHigh impact
Managed Care Entity Bulletin 135: Mental Health Center Policy Updates
MassHealth·MA · Psychiatry·Managed Care
Effective date
Sep 1, 2025
We identified it
Jun 18, 2026
Summary
Effective September 1, 2025, MassHealth is implementing new encounter bundle payment for Behavioral Health Urgent Care providers using procedure code H2013 with modifiers HB (adults) and HA (children/adolescents), and discontinuing the use of GJ modifier for urgent behavioral health services.
Action Required
By September 1, 2025: Billing team must update system to bill H2013 with modifier HB for adult behavioral health urgent care services and HA for child/adolescent services as encounter bundles. Remove GJ modifier from all behavioral health urgent care claims. Configure system to bill bundled services at zero charge using codes from Table 2 alongside the H2013 encounter bundle. Update fee schedules to minimum MassHealth rates per Tables 1 and 3.