Massachusetts MassHealth Behavioral Health Billing: Manuals, Codes and Payers
MassHealth publishes its behavioral health service codes in Subchapter 6 of each provider manual, and most members are enrolled with an accountable care organization (ACO) or managed care plan. This page lists the manuals, the plans, and the codes we confirmed. Checked against state sources on 9/30/26.
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- ✓ MassHealth manuals and Subchapter 6 codes
- ✓ ACOs, the MCO and the MBHP carve-out
- ✓ Codes confirmed in the CBHC and PACT documents
- ✓ WellSense and Community Partners changes
Massachusetts MassHealth Billing at a glance
This page covers massachusetts masshealth billing for behavioral health claims: where the state provider manuals and code lists live, and which HCPCS codes apply to psychotherapists and psychiatrists. Rules vary by state and by payer, so confirm current requirements with the state Medicaid agency before you bill.
Use this Massachusetts MassHealth Billing guide as a starting point. Massachusetts MassHealth Billing rules differ by plan, so check whether a claim goes to the state fee-for-service program or to a managed care plan. Keep a copy of the current Massachusetts MassHealth Billing manual your practice follows, and review your Massachusetts MassHealth Billing process whenever the state issues an update.
MassHealth at a glance
MassHealth is the Massachusetts Medicaid program, run by the Executive Office of Health and Human Services (EOHHS). Each provider type has its own manual, and service codes sit in that manual's Subchapter 6.
State manuals and rate regulations
| Document | What it shows |
|---|---|
| MassHealth provider manuals index | All provider manuals |
| Community Behavioral Health Center (CBHC) manual | CBHC manual page Subchapter 6 service codes (PDF) |
| CBHC transmittal letters (latest: CBHC-4, August 2025) | Transmittals |
| Mental Health Center manual | Manual page |
| Licensed Independent Behavioral Health Clinician manual | Manual page |
| Psychologist manual | Manual page |
| Rates: 101 CMR 305 (CBHCs) | Regulation |
| Rates: 101 CMR 329 (psychologists and clinicians) | Regulation |
ACOs, the MCO and the MBHP carve-out
The state lists 15 ACOs, 2 Primary Care ACOs and 1 MCO. See the full list.
| Plan | Provider site |
|---|---|
| WellSense (all WellSense ACOs and the Essential MCO) | Provider manual Behavioral health |
| Tufts Health Together (Point32Health) | Provider manual |
| Fallon Health | Provider manual MassHealth coverage not confirmed on this page. |
| Mass General Brigham Health Plan | Provider resources |
| BeHealthy Partnership and MBHP (behavioral health carve-out) | MBHP provider site |
| Community Care Cooperative (C3) | Provider manual |
| Revere Health Choice | Policies and forms |
Codes confirmed in state documents
From CBHC transmittal 4 (August 2025), the PACT Subchapter 6 (effective 11/1/2025) and the Community Support Program covered codes (4/28/2023). Check the manual for your provider type.
| Code | What the document calls it |
|---|---|
| H2015 | Community Support Program, per 15 minutes, no modifier; H2015 HF is Recovery Support Navigator (CBHC) |
| H2016 | Community Support Program per diem with HK, HH or HE; H2016 HM is recovery coaching per diem (CBHC) |
| H0040 U1, U2 | Program of Assertive Community Treatment (PACT), per diem |
| H2011 | Crisis intervention, per 15 minutes |
| H0004 | Behavioral health counseling and therapy, per 15 minutes |
| H0005, H0015, H0033 | Alcohol and drug group counseling; intensive outpatient; oral medication administration |
| H0046 HE | Certified Peer Specialist |
| T1006 | Family and couple counseling |
| T1040 HA / HB | Certified Community Behavioral Health Clinic per diem (HA child and adolescent; HB adult) |
| S9480 | Intensive outpatient psychiatric services, per diem |
| S9485 | Crisis stabilization and mobile crisis, several modifiers |
| H0036, H2020 | Not found in the CBHC-4 document or the children's rate documents we read. Do not state them for MassHealth from those sources. |
Children's behavioral health (CBHI)
These are MassHealth Children's Behavioral Health Initiative services. Codes and modifiers come from the proposed 101 CMR 352.00 (filed 3/28/2025) and the accountable care partnership plan contract, Appendix AA. We could not read the final rule effective 9/1/2025, so confirm each row against it. H2019 is used here with HN and HO; H2020 was not found.
| Code | What the document calls it |
|---|---|
| H2019 HN | Therapeutic behavioral services: In-Home Therapy, therapeutic training and support by a bachelor-level clinician, per 15 minutes |
| H2019 HO | Therapeutic behavioral services: In-Home Therapy by a master-level clinician, per 15 minutes |
| H2014 HN | Skills training and development: In-Home Behavioral Services, behavior management monitoring by a bachelor-level clinician, per 15 minutes |
| H2014 HO | Skills training and development: In-Home Behavioral Services, behavior management therapy by a master-level clinician, per 15 minutes |
| T1027 EP | Family training and counseling for child development: Therapeutic Mentoring, per 15 minutes |
| H0023 HT | Behavioral health outreach: Intensive Care Coordination, per day |
| H0038 | Self-help and peer services: Family Support and Training by a family partner, per 15 minutes |
| H2011 HN, H2011 HO | Crisis intervention: Youth Mobile Crisis Intervention (paraprofessional or master's level), per 15 minutes |
| H0046 HT | Family-based Intensive Treatment, per week (new service) |
What is changing
Current as of the last search. Reconfirm before publishing or billing.
- WellSense behavioral health. WellSense moved behavioral health in-house on 1/1/2026 (New Hampshire on 12/1/2025). Continuity of care ran through 4/30/2026, and claims without required taxonomy codes are denied starting 9/1/2026. WellSense behavioral health page
- Community Partners program. It ended 6/30/2026. ACOs and the MCO no longer have to contract with Community Partners. Managed Care Entity Bulletin 144
- Manuals. The CBHC manual took effect 8/15/2025 and the PACT chapter 11/1/2025.
Massachusetts Medicaid billing: frequently asked questions
Where are MassHealth service codes listed?
In Subchapter 6 of each MassHealth provider manual. The Community Behavioral Health Center manual has its own Subchapter 6, and transmittal CBHC-4 (August 2025) updated it.
Who manages behavioral health for MassHealth members?
It depends on the member's plan. Many ACOs and the MCO now manage it themselves, and the state lists MBHP for the Primary Care Clinician plan, Primary Care ACOs and some fee-for-service members. Verify the plan on each visit.
Did WellSense change how it handles behavioral health?
Yes. WellSense moved behavioral health in-house on 1/1/2026, and taxonomy-code denials start 9/1/2026. Confirm which of its plans are covered.
Does MassHealth use H0040?
Yes, for the Program of Assertive Community Treatment, billed per diem with U1 or U2 under the PACT Subchapter 6 effective 11/1/2025.
Where this information comes from
- MassHealth provider manuals
- CBHC manual
- CBHC transmittals
- Full list of MassHealth ACOs and MCOs
- WellSense behavioral health
- MBHP provider site
- Managed Care Entity Bulletin 144
- 101 CMR 352.00 proposed rates for children's behavioral health services (filed 3/28/2025)
- ACPP contract Appendix AA, CBHI rate increases
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