The following services are not reimbursable:

1. (A) drugs and durable medical equipment prescribed for take-home use that are readily available from pharmacies or medical providers;
2. (B) the cost of any treatment or testing of a member or of a specimen from a member who is not an inpatient in the psychiatric inpatient hospital;
3. (C) room-and-board services on the day of discharge (unless the day of discharge is also the day of admission);
4. (D) leave-of-absence days;
5. (E) research or the provision of experimental or unproven procedures;
6. (F) private hospital rooms, except when medically necessary; and
7. (G) services furnished by the emergency room or outpatient department on the day of admission, during the inpatient stay, or on the day of discharge.

Commonwealth of Massachusetts Subchapter Number and Title Page

MassHealth 4. Program Regulations

4-6

Provider Manual Series (130 CMR 425.000)

Transmittal Letter Date

Psychiatric Inpatient Hospital Manual

PIH-23 06/16/17