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HOUSE DOCKET, NO. 1566 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 2220
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Kathleen R. LaNatra
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to access to psychiatric collaborative care.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Kathleen R. LaNatra12th Plymouth1/15/2025Michael D. BradySecond Plymouth and Norfolk2/6/2025Bud L. Williams11th Hampden2/11/2025 1 of 4
HOUSE DOCKET, NO. 1566 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 2220
By Representative LaNatra of Kingston, a petition (accompanied by bill, House, No. 2220) of
Kathleen R. LaNatra, Michael D. Brady and Bud L. Williams relative to healthcare coverage for
psychiatric collaborative care. Mental Health, Substance Use and Recovery.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act relative to access to psychiatric collaborative care.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 177 of the acts of 2022 is hereby amended by striking out Section
284 and inserting in
3 place thereof the following section:-
4 Section 84. For the purposes of section 22A of chapter 32A of the General Laws, section
510P of chapter 118E of the General Laws, section 47QQ of chapter 175 of the General Laws,
6section 8RR of chapter 176A of the General Laws, section 4RR of chapter 176B of the General
7Laws and section 4JJ of chapter 176G of the General Laws, reimbursement for the psychiatric
8collaborative care model shall include, but not be limited to, the following current procedural
9terminology billing codes: (i) 99492; (ii) 99493; (iii) 99494; and (iv) G2214.
10 SECTION 2. Chapter 118E of the General Laws is hereby amended by inserting after
11section 13L the following section:- 2 of 4
12 Section 13M. (a) For the purposes of this section, “psychiatric collaborative care model”
13shall mean the evidence-based, integrated behavioral health service delivery method in which a
14primary care team consisting of a primary care provider and a care manager provides structured
15care management to a patient, and that works in collaboration with a psychiatric consultant that
16provides regular consultations to the primary care team to review the clinical status and care of
17patients and to make recommendations.
18 “Managed care entity”, all contracted health insurers, health plans, health maintenance
19organizations, behavioral health management firms and third party administrators under contract
20to a Medicaid managed care organization or primary care clinician plan, and accountable care
21organizations.
22 “Minimum payment rates”, rates of payment for services below which managed care
23entities may not enter into provider agreements.
24 (b) The division shall increase minimum payment rates for psychiatric collaborative care
25model billing codes such that they are equal to or greater than the current Medicare Resource-
26Based Relative Value Scale physician fee schedule for such codes and adjusted annually.
27 (c) Notwithstanding applicable state and federal laws, the division shall direct its
28managed care entities to increase minimum payment rates for psychiatric collaborative care
29model billing codes such that they are equal to or greater than the current Medicare Resource-
30Based Relative Value Scale physician fee schedule for such codes and adjusted annually.
31 (d) Pursuant to sections 13C and 13D, and notwithstanding applicable state and federal
32laws, the division shall ensure that psychiatric collaborative care model billing codes are
33removed from the defined set of billing codes included in the division’s accountable care 3 of 4
34organization primary care sub-capitation per-member per-month rate and that said codes shall be
35paid on a fee-for-service basis.
36 SECTION 3. Section 22A of Chapter 32A of the General Law, as so appearing, is hereby
37amended by inserting after the second paragraph the following paragraphs:-
38 (c) The commission shall increase minimum payment rates for psychiatric collaborative
39care model billing codes such that they are equal to or greater than the current Medicare
40Resource-Based Relative Value Scale physician fee schedule for such codes and adjusted
41annually.
42 SECTION 4. Section 47QQ of Chapter 175 of the General Law, as so appearing, is
43hereby amended by inserting after the second paragraph the following paragraph:-
44 (c) An individual policy of accident and sickness insurance issued pursuant to section 108
45that provides hospital expense and surgical expense insurance or a group blanket or general
46policy of accident and sickness insurance issued pursuant to section 110 that provides hospital
47expense and surgical expense insurance that is issued or renewed within or without the
48commonwealth shall increase minimum payment rates for psychiatric collaborative care model
49billing codes such that they are equal to or greater than the current Medicare Resource-Based
50Relative Value Scale physician fee schedule for such codes and adjusted annually.
51 SECTION 5. Section 8RR of Chapter 176A of the General Law, as so appearing, is
52hereby amended by inserting after the second paragraph the following paragraph: -
53 (c) A contract between a subscriber and the corporation under an individual or group
54hospital service plan which is delivered, issued or renewed within the commonwealth shall 4 of 4
55increase minimum payment rates for psychiatric collaborative care model billing codes such that
56they are equal to or greater than the current Medicare Resource-Based Relative Value Scale
57physician fee schedule for such codes and adjusted annually.
58 SECTION 6. Section 4RR of Chapter 176B of the General Law, as so appearing, is
59hereby amended by inserting after the second paragraph the following paragraph:-
60 (c) A subscription certificate under an individual or group medical service agreement that
61is issued or renewed within the commonwealth shall increase minimum payment rates for
62psychiatric collaborative care model billing codes such that they are equal to or greater than the
63current Medicare Resource-Based Relative Value Scale physician fee schedule for such codes
64and adjusted annually.
65 SECTION 7. Section 4JJ of Chapter 176G of the General Law, as so appearing, is hereby
66amended by inserting after the second paragraph the following paragraph:-
67 (c) Any individual or group health maintenance contract that is issued or renewed within
68the commonwealth shall increase minimum payment rates for psychiatric collaborative care
69model billing codes such that they are equal to or greater than the current Medicare Resource-
70Based Relative Value Scale physician fee schedule for such codes and adjusted annually.