We’re offering some important reminders around the correct billing practices for short-term behavioral health (BH) inpatient stays. (Please keep in mind that the following guidance does not apply to inpatient acute medical admissions.)

As you may know, it is not appropriate to submit interim bills for BH inpatient treatment when the length of stay is less than 30 days. 

When the length of stay is 1-30 days, including claims for BH services that are reimbursed per diem, the claim should be submitted as one inpatient stay using bill type 111. 

In addition, please keep the following rules in mind regarding the fields included on the bill: 

  • The statement “From” date must be before or equal to the admission date.
  • Per MassHealth billing guidelines, do not count the statement “Through” date (discharge date) as a covered day.
  • The status code should indicate that the patient has been discharged.
  • Submit one procedure code per date of service.
  • Do not submit separate claims for consecutive-day stays.

If the total length of stay is one day, distinct billing dates must be used; the “From” (admission) and “Through” (discharge) dates cannot be the same.