If you provide preventive behavioral health services to eligible Tufts Health Together members under the age of 21 in a Community Health Center (CHC), we’d like to make you aware of a recent change in MassHealth’s billing guidance. Effective Jan. 1, 2026, as specified in Managed Care Entity Bulletin 143, the following codes are reimbursable for preventive behavioral health services: 

  • T1040: Community Behavioral Health Clinic Service, Per Diem 
  • T1040-HQ: Group Setting 

CHCs can continue to request reimbursement for services using the codes below, as appropriate, but please keep in mind that if you bill using codes T1040 or T1040-HQ, you may not bill for any of the services below for the same member, on the same date, at the same location. Claims submitted incorrectly as of Jan. 1, 2026 will be reprocessed and any overpayment will be retracted. 

  • 90832: Psychotherapy with patient and/or family member 
  • 90834: Psychotherapy with patient and/or family member 
  • 90846: Family psychotherapy (conjoint psychotherapy) (without patient present) 
  • 90847: Family psychotherapy (conjoint psychotherapy) (with patient present) 
  • 90849: Multiple-family group psychotherapy 
  • 90853: Group psychotherapy (other than multiple-family group) 

While the billing instructions for preventive behavioral health services outlined above from Managed Care Entity Bulletin 143 supersede those found in Managed Care Entity Bulletin 65, all other aspects of MCE Bulletin 65 remain in effect. For example, all claims for preventive behavioral health services for members younger than 21 must be submitted with modifier EP and must include the most clinically appropriate ICD diagnosis code, including Z codes that may be used as the primary diagnosis, when clinically appropriate. 

We’ve updated Point32Health’s Outpatient Behavioral Health & Substance Use Disorder Payment Policy to align with the state’s most recent guidance.