(1) Rate Determination. Rates of payment for authorized services to which 101 CMR 339.00 applies are the lower of
- (a) the usual fee of the eligible provider of rehabilitation center services or the eligible provider of restorative services to patients other than publicly aided individuals; or
- (b) the schedule of allowable fees set forth in 101 CMR 339.04.
- (2) Out-of-office Rates. With the exception of services provided by rehabilitation centers and speech and hearing centers, the fee for any service provided out of the office will be 115% of the respective in-office fee.
- (3) Multiple Procedures in Physical Therapy. When more than one type of physical therapy treatment is provided in a single visit, the provider receives 100% of the applicable fee for each procedure, with a maximum of four procedures (or a total of one hour) allowed in a given visit.
- (4) Special Contracts. In certain circumstances, purchasing agencies may pay for services on an hourly basis, rather than a per visit basis as described in 101 CMR 339.00. A special contract would be appropriate where a large number of patients are treated by an individual practitioner on a regular basis for a particular purchaser at one site and/or where the treatment times described in the service codes in 101 CMR 339.00 do not define the treatment times authorized by the purchaser.