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Managed Care Entity Bulletin 135: Mental Health Center Policy Updates
Effective date
Sep 1, 2025
Identified
Jun 18, 2026
Summary
Effective September 1, 2025, managed care entities must pay behavioral health urgent care providers (BHUCs) one encounter bundle per patient per day instead of each individual service, billed as H2013 with modifier HB for adults or HA for children and adolescents, at no less than the MassHealth fee-for-service minimum rate for the bundle code. The services listed in Table 2 are included in the bundle and must be reported on the claim with a zero charge. The GJ modifier for urgent services is not allowed beginning September 1, 2025.
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What to do
Action · 5 steps
01Already effective September 1, 2025: Providers rendering the designated services at BHUC sites, across all licensure levels, bill those services with the single H2013 encounter bundle code for each patient per day, using modifier HB for adults or HA for children and adolescents, regardless of how many services were provided that day.
02On the same claim, providers report each service included in the bundle using the Table 2 service codes with a zero charge.
03Services not included in Table 2 that are provided at BHUC sites are subject to the Table 3 minimum fee schedule.
04Providers stop billing the GJ modifier for urgent services: BHUCs use the encounter bundle and zero-bill codes instead, and mental health centers that are not designated as BHUCs will not be able to bill the GJ modifier when submitting claims for urgent services.
05For mental health centers that are not designated as BHUCs, managed care entities must pay no less than the Table 3 minimum fee schedule rates for the Table 2 services.
Codes mentioned
H201390791HA90792908329083390834908369083790846908479084990853EP90870908829088799202992039920499205992119921299213992149921599402994049941796116961219613096131961329613396136961379613896139H0015H0032H0046H2015H2016H2020S9480S9484
Original notice
Managed Care Entity Bulletin 135: Mental Health Center Policy Updates
mass.gov · Always check the source before changing claims.
Related changes
See all MassHealth changes →All Provider Bulletin 408: Annual Behavioral Health Wellness ExaminationsHighEffective Sep 23, 2025 · Specialty ServicesAll Provider Bulletin 419: Transition to Separate Reporting of Maternity Care ServicesHighEffective Sep 1, 2026 · Provider BulletinManaged Care Entity Bulletin 143: Preventive Behavioral Health Services for Members Younger than 21MediumEffective Jan 1, 2026 · Managed CareCommunity Health Center Bulletin 125: Preventive Behavioral Health Services for Members Younger than 21HighEffective Jan 1, 2026 · Specialty ServicesBrowse every MassHealth change in the policy list
Related policy hubs
MassHealth policiesMA policy changesPsychiatryPediatricsCode H2013Code 90791Code HACode 90792Code 90832Code 90833Code 90834Code 90836Code 90837Code 90846Code 90847Code 90849Code 90853Code EPCode 90870Code 90882Code 90887Code 99202Code 99203Code 99204Code 99205Code 99211Code 99212Code 99213Code 99214Code 99215Code 99402Code 99404Code 99417Code 96116Code 96121Code 96130Code 96131Code 96132Code 96133Code 96136Code 96137Code 96138Code 96139Code H0015Code H0032Code H0046Code H2015Code H2016Code H2020Code S9480Code S9484