Issued: April 15, 2024

Partners Health Management is reviewing the utilization rates for Peer Support Services (PSS) H0038 to ensure network adequacy standards are met and to avoid over utilization. PSS is managed by Partners Utilization Management department (UM).

What is happening?

Partners is reviewing utilization rates for Peer Support Services H0038 to ensure network adequacy and avoid over utilization.

Any provider that has the PSS code in their contract and has not billed service code H0038 in fiscal year 2024 (July 1, 2023-June 30, 2024) will have the code removed from their contract effective 30 days from this notice.

What do providers need to do?

Any provider that has provided this service and has outstanding billing for fiscal year 2024 should contact their provider account specialist at PAS@PartnersBHM.org to ensure that timely billing can occur.

Where can providers find more information?

Providers can find more information in their Medicaid contract, Section 3.1, Claims or Encounter Data Submission, or in Partners Provider Operations Manual.

Who can providers contact with questions?

If they have questions, providers can email PAS@PartnersBHM.org.