Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth

Table of Contents iv

Provider Manual Series

Transmittal Letter Date

Day Habilitation Manual

DH-33 10/11/24

130 CMR 419.000: Day Habilitation Center Services

4. Program Regulations

419.401: Introduction ................................................................................................................. 4-1 419.402: Definitions ................................................................................................................... 4-1 419.403: Eligible Members ........................................................................................................ 4-4 419.404: Provider Eligibility ...................................................................................................... 4-5 419.405: Scope of Day Habilitation ........................................................................................... 4-6 419.406: Clinical Eligibility Criteria .......................................................................................... 4-6 419.407: Service Needs Assessment, Leveling Tool, and Prior Authorization ........................... 4-7 419.408: Quality Management ................................................................................................... 4-9 419.409: Conditions of Payment ................................................................................................ 4-9 419.410: Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services ............. 4-10 419.411: Transportation Services ................................................................................................ 4-10 (130 CMR 419.412 through 419.415 Reserved) 419.416: Day Habilitation Provider Responsibilities ................................................................. 4-12 (130 CMR 419.417 through 419.418 Reserved) 419.419: Day Habilitation Service Plan (DHSP) ....................................................................... 4-17 419.420: Discharge ..................................................................................................................... 4-18 419.421: Day Habilitation Staff Qualifications, Responsibilities, and Training ........................ 4-18 (130 CMR 419.422 through 419.429 Reserved) 419.430: Emergency Services and Plans ..................................................................................... 4-25 419.431: Noncoverage ................................................................................................................ 4-26 419.432: Physical Site ................................................................................................................ 4-27 419.433: Day Habilitation for MassHealth Members with ID/DD Residing in NFs ................. 4-28 419.434: Withdrawal of a Day Habilitation Provider from MassHealth .................................... 4-31 (130 CMR 419.435 through 419.441 Reserved)

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-1

Provider Manual Series (130 CMR 419.000)

Transmittal Letter Date

Day Habilitation Manual

DH-33 10/11/24