As part of MassHealth’s recent expansion of Community Support Program (CSP) Services, members of the Tufts Health Plan Together, Tufts Health Unify, and Tufts Health Plan Senior Care Options products have access to services to assist with the health-related social needs of individuals who are experiencing housing instability, homelessness, or justice involvement.
The following provides an overview of the programs, as well as important information on billing and providing notification, which is required for each of these programs.
Community Support Program for Homeless Individuals (CSP-HI)
This program is available to homeless members who frequently utilize MassHealth’s acute care services. CSP-HI provides assistance to members before, during, and after transitioning into housing. Coverage is effective for dates of service on or after April 1, 2023.
Notification to Tufts Health Plan is required and should be provided by completing this form and returning it by fax to the appropriate number listed at the top of the form.
When billing for these services, please ensure that you submit claims using HCPCS code H2016 (comprehensive community support services, per diem) with the modifier HK (specialized mental health programs for high-risk populations). In addition, the appropriate secondary diagnosis code must also be included to reflect the member’s housing situation:
- Z59.00 – Homelessness, unspecified
- Z59.01 – Sheltered homelessness
- Z59.02 – Unsheltered homelessness
Community Support Program Tenancy Preservation Program (CSP-TPP)
This program serves members who are at risk of homelessness and eviction due to disability-related behavior. Through CSP-TPP, members are connected to community-based services that will help them address the causes of the behavior that led to lease violations. Coverage is effective for dates of service on or after April 1, 2023.
Notification to Tufts Health Plan is required and should be provided by completing this form and returning it by fax to the appropriate number listed at the top of the form.
When billing for CSP-TPP services, please ensure that you submit claims using code H2016 (comprehensive community support services, per diem) with the HE (mental health program) modifier. The secondary diagnosis code of Z59.811 (housing instability) must also be included.
Community Support Program for Individuals with Justice Involvement (CSP-JI)
This program provides health care coordination and support for members with justice involvement including those who were previously detained or incarcerated in a correctional facility. Coverage was effective as of Sept. 1, 2022 for Tufts Health Together members. For Tufts Health Senior Care Options and Tufts Health Unify members, coverage was effective as of Jan. 1, 2023.
To provide notification to Tufts Health Plan for the CSP-JI program, please complete the CSP-JI Notification form and return it by fax to the appropriate number listed at the top of the form.
When billing for these services, please ensure that you submit claims using the code H2016 (comprehensive community support services, per diem) and HH modifier (integrated mental health/substance abuse program).
Additional program information and details can be found at:
- Community Support Program for Homeless Individuals (CSP-HI)
- Community Support Program Tenancy Preservation Program (CSP-TPP)
- Community Support Program for Individuals with Justice Involvement (CSP-JI)
- Community Support Programs (CSP)
Editor’s note: This article was updated on 8/17/23 to reflect housing instability code change from Z59.81 to Z59.811. On Nov. 14, 2023, the article was further updated to remove a line saying the secondary diagnosis Z code is required for Community Support Program for Individuals with Justice Involvement, as this secondary diagnosis code is not required for the CSP-JI service.
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