(A) The MassHealth agency pays for one nurse to provide CSN services simultaneously to more than one member, but not more than three members, if
- (1) the members have been determined by the MassHealth agency or its designee to meet the criteria listed at 130 CMR 414.408;
- (2) the members receive services in the same household and during the same time period;
- (3) the MassHealth agency or its designee has determined that it is appropriate for one nurse to provide nursing services to the members simultaneously; and
- (4) the independent nurse has received a separate prior authorization from the MassHealth agency or its designee for each member as described in 130 CMR 414.413.
- (B) Services provided pursuant to 130 CMR 414.410(A) must be billed by using the multiple- patient service code and modifier that reflects the number of members receiving the services.