If you provide residential substance use disorder treatment for Tufts Health RITogether members, please be aware that in accordance with recent direction from the Rhode Island Executive Office of Health and Human Services, effective for dates of service beginning Jan. 1, 2026 you’ll be required to use form CMS-1500 and place of service (POS) code 55 (Residential Treatment Facility) when submitting your claims for reimbursement. 

Please continue to use the current HCPCS code and modifier combinations below that you use today.

ASAM Level Code/Modifier
3.1H0018 UD
3.5H0010 UD
3.7 / 3.7 WMH0011 UD

For dates of service beginning Jan. 1, 2026, claims for residential substance use disorder treatment submitted using form UB-40 and POS code 21 (Inpatient Hospital) will no longer be accepted, and will be denied.

Refer to our updated Inpatient and Intermediate/Diversionary Behavioral Health/Substance Use Disorder (BH/SUD) Facility Payment Policy for additional guidance.