If you are a Community Behavioral Health Center (CBHC) providing behavioral health services for Tufts Health Direct members, you must bill using the individual procedure code that represents the actual services rendered. 

Point32Health will not accept or reimburse claims using the bundled MassHealth Medicaid HCPCS code T1040 for behavioral health services provided by a CBHC to Tufts Health Direct plan members.

As noted in Point32Health’s Outpatient Behavioral Health & Substance Use Disorder Payment Policy, reimbursement for these services based on the bundled code T1040 only applies to members enrolled in Tufts Health Together plans in accordance with MassHealth requirements. These services are not reimbursed as a bundled payment under the Tufts Health Direct plans.   

CBHCs may continue to use bundled code T1040 for covered services for Tufts Health Together members.