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Health and Human Services

DHCFP Regulations


DHCFP regulations are available as both PDF and Word files for easy viewing, downloading, and printing.

Regulations (as well as any proposed regulations, bulletins, and notices) are listed in:
- Alphabetical Order (by name and service type)
- Numerical Order (by CMR number)

Alphabetical Order (by name and service type)

Community Health Care Providers (Ambulatory Care)

Abortion and Sterilization Services
Adult Day Health Services
Adult Foster Care
Ambulance Services
Children's Behavioral Health Services
Chiropractic Services
Clinical Laboratory Services
Community Health Centers
Day Habilitation Programs
Dental Services
Dialysis Treatment (Chronic Maintenance and Home Dialysis Supplies)
Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment
Early Intervention Program Services
Family Planning Services
Freestanding Ambulatory Surgical Facilities
Hearing Aid Dispensers
Home Health Services
Hospice Services
Independent Living Services  (Personal Care Attendants)
Medicine
Mental Health Services (in CHCs and MHCs)
Prescribed Drugs
Podiatric Care
Prostheses, Prosthetic Devices, and Orthotic Devices
Psychological Services
Psychiatric Day Treatment
Radiology
Rehabilitation Clinics, Audiological Services, and Restorative Services
Substance Abuse Programs
Surgery and Related Anesthesia
TEAM Evaluation Services
Temporary Nursing Services
Tuberculosis Control Services (Outpatient)
Vision Care Services / Ophthalmic Materials
Worker's Compensation

Hospitals / Nursing Homes and Rest Homes

Acute Care Hospitals
Case Mix Data Submission (Hospitals)
Disclosure of Hospital Case Mix and Charge Data
Hospital Financial Reports
Intermediate Care Facilities (Department of Mental Retardation)
Nursing Facilities
Nursing Facility User Fees
Resident Care Facilities (Rest Homes)
Worker's Compensation (Hospital Industrial Accident Patients)

Health Safety Net

Health Safety Net Eligible Services
Health Safety Net Payments and Funding

Health Care Reform Implementation -- Employer Requirements

Determination of the Employer Fair Share Contribution
Employer Surcharge for State-Funded Health Costs
Health Insurance Responsibility Disclosure (HIRD - Employer and Employee Forms available)

Other DHCFP Regulations

Health Plan Data (Report Card)
Rates for Certain Social, Rehabilitation, and Health Care Consultant Services
Student Health Insurance


Numerical Order (by CMR number)

 

Regulation Name
(Effective Date)

 Format


 114.1 CMR 17.00

Requirement for the Submission of
Hospital Case Mix and Charge Data
(October 1, 2006)
 PDF Word
Update for Present on Admission
(November 19, 2007)
 PDF Word
Case Mix Submissions- FAQ
(February 2, 2007)
 PDF Word
Submission Update
(December 19, 2006)
 PDF  Word
Data Specifications: ---- ----
Hospital Inpatient Discharge: Data Specifications
(October 2008)
 PDF Word
Hospital Emergency Department: Data Specifications
(September 2006)
 PDF Word
Hospital Emergency Department: Summary of Changes
(June 2006)
 PDF Word
Hospital Outpatient Observation: Data Specifications
(September 2006)
 PDF Word
Hospital Outpatient Observation: Summary of Changes
(June 2006)
 PDF Word
Previous Information/Submission Updates: ---- ----
Hospital Inpatient Discharge: Data Specifications
(September 2006)
 PDF Word (1.5 MB)
Hospital Inpatient Discharge: Summary of Changes
(June 2006)
 PDF Word
Submission Update
(September 14, 2006)
 PDF Word
Hierarchy for Mapping Ethnicity
(September 14, 2006)
 PDF Word
Summary of Adopted Changes
(July 20, 2006)
 PDF Word
Summary of Proposed Changes
(May 11, 2006)
 PDF Word


 114.1 CMR 29.00

Proposed Regulation
Rate and Charge Determination for Certain Intermediate
Care Facilities for the Mentally Retarded Operated by
the Department of Mental Retardation
(January 1, 2009)
 PDF Word
Current Regulation
Rate and Charge Determination for Certain Intermediate
Care Facilities for the Mentally Retarded Operated by
the Department of Mental Retardation
(January 1, 2007)
 PDF Word


 114.1 CMR 36.00

Acute Care Hospital Charges and Rates of Payment for Certain Publicly Assisted Individuals
(December 1, 2007)
 PDF Word


 114.1 CMR 41.00

Rates of Payment for Services Provided to Industrial
Accident Patients by Hospital
(January 1, 2004)
 PDF Word
Bulletin: Application of the Payment on Account Factor (PAF) to Hospital Charges
(September 18, 2008)
  PDF Word


 114.1 CMR 42.00

Hospital Financial Reports
(November 15, 2006)
 PDF Word
Bulletin: FY07 DHCFP-403 Revisions
(November 29, 2007)
 PDF Word
Bulletin: Coding Updates
(November 10, 2005)
 PDF Word
link to: DHCFP-INET Online Reporting System Information ---- ----


 114.2 CMR 4.00

Resident Care Facilites: Rest Homes (December 1, 2007) PDF Word
Notice: Proposed Amendments to Resident Care Facilities: Rest Homes (October 20, 2008) PDF  Word


 114.2 CMR 6.00

Standard Payments to Nursing Facilities
(October 1, 2008)
 PDF Word
Nursing Home Rates
(July 1, 2008)
 PDF Excel
Bulletin: Nursing Facility Direct Care Add-On Compliance
(July 13, 2007)
 PDF Word
link to: Nursing Facilty Reports ---- ----


 114.3 CMR 3.00

see 114.3 CMR 50.00 ---- ----


 114.3 CMR 4.00

Rates for Community Health Centers
(October 1, 2007)
 PDF Word
Bulletin: Coding Updates
(October 1, 2006)
 PDF Word
Rates for Community Health Centers
(November 1, 2004)
 PDF Word


 114.3 CMR 6.00

Rates of Payment for Mental Health Services Provided in Community Health Centers and Mental Health Centers
(September 1, 2008)
 PDF Word


 114.3 CMR 7.00

Psychiatric Day Treatment Center Services
(January 1, 2008)
 PDF Word


 114.3 CMR 8.00

Outpatient Tuberculosis Control Services
(August 1, 2007)
 PDF Word


 114.3 CMR 9.00

Independent Living Services for the Personal Care Attendant Program
(January 1, 2008)
 PDF Word
Bulletin: Update to the Employer Expense Component Rates
(April 6, 2008)
 PDF Word


 114.3 CMR 10.00

Adult Day Health Services
(November 1, 2007)
 PDF Word
Bulletin: Revisions to Cost Report Due Dates (November 1, 2008) PDF Word


 114.3 CMR 12.00

Family Planning Services
(January 1, 2008)
 PDF Word


 114.3 CMR 13.00

Rates for Freestanding Clinics Providing Abortion and Steralization Services
(August 1, 2007)
 PDF Word


 114.3 CMR 14.00

Proposed Regulation
Dental Services
(January 1, 2009)
 PDF Word
Notice of Public Hearing
Tuesday, January 6, 2009 at 10:00 a.m.
 PDF Word
Current Regulation
Dental Services
(October 1, 2007)
 PDF Word
Bulletin: Additions to Eligible Provider List for Fluoride Varnish Service
(October 1, 2008)
 PDF Word


 114.3 CMR 15.00

Vision Care Services and Ophthalmic Materials
(March 1, 2008)
 PDF Word


 114.3 CMR 16.00

Emergency Adopted Regulation
Surgery and Anesthesia Services
(December 1, 2008)
 PDF
(1.7 MB)
 Word 
(4.6 MB)
Notice of Public Hearing
Tuesday, January 13, 2009 at 10:00 a.m.
 PDF Word
Previous Regulation
Surgery and Anesthesia Services
(July 1, 2008)
 PDF
(1.7 MB)
 Word 
(4.5 MB)


 114.3 CMR 17.00

Emergency Adopted Regulation
Medicine
(December 1, 2008)
 PDF Word
(2.5 MB)
Notice of Public Hearing
Tuesday, January 13, 2009 at 10:00 a.m.
 PDF Word
Previous Regulation
Medicine
(July 1, 2008)
 PDF Word
(1 MB)


 114.3 CMR 18.00

Emergency Adopted Regulation
Radiology
 PDF Word
Notice of Public Hearing
Tuesday, January 13, 2009 at 10:00 a.m.
 PDF Word
Previous Regulation
Radiology
(July 1, 2008)
 PDF Word


 114.3 CMR 20.00

Clinical Laboratory Services
(October 1, 2007)
 PDF Word
Bulletin: Procedure Code Update
(January 1, 2008)
 PDF Word
Bulletin: Coding Updates
(January 1, 2006)
 PDF Word
Bulletin: Coding Updates
(January 1, 2005)
 PDF Word


 114.3 CMR 22.00

Durable Medical Equipment, Oxygen, and Respiratory Therapy Equipment
(July 1, 2007)
 PDF Word 
(1.1MB)
Bulletin: HCPCS Updates and Corrections
(June 1, 2008)
 PDF Word
Bulletin: HCPCS Updates and Corrections
(November 1, 2007)
 PDF Word
Bulletin: HCPCS Updates and Corrections
(October 1, 2007)
 PDF Word


 114.3 CMR 23.00

Hearing Aid Dispensers
(January 1, 2007)
 PDF Word
Hearing Aid Dispensers
(October 1, 2003)
 PDF Word
Bulletin: Coding Updates
(January 1, 2006)
 PDF Word
Bulletin: Coding Updates
(January 21, 2005)
 PDF Word


 114.3 CMR 26.00

Podiatric Care - Effective May 15, 2005, Podiatrists are eligible providers under regulation 114.3 CMR 17.00. Please refer to that regulation now, as this regulation is in the process of being rescinded. 


 114.3 CMR 27.00

Ambulance Services
(May 1, 2008)
 PDF Word

Bulletin: Clarification of Air Ambulance Rates for Worker’s Compensation Payments
(September 25, 2008)

PDF Word


 114.3 CMR 28.00

Chiropractic Services
(July 1, 2005)
 PDF Word


 114.3 CMR 29.00 

Psychological Services
(January 1, 2008)
 PDF Word
Bulletin: Coding Updates
(January 1, 2006)
 PDF Word


 114.3 CMR 30.00

TEAM Evaluation Services
(July 1, 2004)
 PDF Word


 114.3 CMR 31.00

Prescribed Drugs
(August 1, 2008)
 PDF Word
Bulletin: Massachusetts Upper Limit
(November 1, 2007)
 PDF Word


 114.3 CMR 34.00

Prostheses, Prosthetic Devices, and Orthotic Devices
(June 1, 2007)
 PDF Word
Bulletin: Coding Updates
(June 1, 2008)
 PDF Word
Bulletin: Coding Updates
(June 1, 2007)
 PDF Word


 114.3 CMR 37.00

Chronic Maintenance Dialysis Treatments and
Home Dialysis Supplies
(June 1, 2007)
 
PDF
 
Word


 114.3 CMR 39.00

Rehabilitation Clinic Services, Audiological Services, Restorative Services
(August 1, 2008)
 PDF  Word


 114.3 CMR 40.00 

Rates for Service Under M.G.L. c. 152,
Worker's Compensation Act
(September 1, 2004)
[To download the Word file, save it to your hard drive before opening.]
 PDF
(3.6MB)
 Word
(17.4MB)

Bulletin: Clarification of Air Ambulance Rates for Worker’s Compensation Payments
(September 25, 2008)

PDF Word
Bulletin: Coding Updates
(November 19, 2004)
 PDF Word
Acupuncture (Word)
Anesthesia Services (Word)
Chiropractic Services (Word)
Clinical Laboratory Services (Word) 
Dental Services (Word)
Durable Medical Equipment, Prosthetics/Orthotics, and Supplies (DMEPOS) (Word)
Freestanding Diagnostic Facilities/Radiology (Word)
Freestanding Surgical Services/Surgery (Word)
Homemaker (Word)
Medicine (Word)
Psychology (Word)
Radiology (Word)
Rehabilitation Clinical Services, Audiological Services, Restorative Services (Word)
Surgery (Word)


 114.3 CMR 43.00

Hospice Services
(October 1, 2006)
 PDF Word
Bulletin: Rate Update
(October 1, 2007)
 PDF Word


 114.3 CMR 45.00

Temporary Nursing Services
(May 5, 2008)
 PDF Word
Temporary Nursing Services
(March 1, 2008)
 PDF Word


 114.3 CMR 46.00

Rates for Certain Substance Abuse Programs
(July 1, 2008)
 PDF Word


 114.3 CMR 47.00

Freestanding Ambulatory Surgical Facilities
(May 1, 2006)
 PDF Word
(1.5MB)

Bulletin: Coding Updates (February 2, 2007)

 PDF Word


 114.3 CMR 48.00

Day Habilitation Program Services
(February 15, 2008)
 PDF Word
Bulletin: Reporting Requirements
(August 19, 2005)
 PDF Word


 114.3 CMR 49.00

Rates for Early Intervention Program Services
(November 1, 2006)
 PDF Word
Early Intervention Program Services
(January 1, 2005)
 PDF Word


 114.3 CMR 50.00
 (formerly 114.3 CMR 3.00 and 114.3 CMR 24.00)

Emergency Adopted Regulation
Home Health Services
(December 1, 2008)
  PDF Word
Notice of Public Hearing
Thursday January 22, 2009 at 10:00 a.m.
 PDF Word
Previous Regulation
Home Health Services
(January 1, 2007)
 PDF Word
Bulletin: Minimum Compensation Review
(October 4, 2007)
 PDF Word
Bulletin: Minimum Nursing Compensation Values
(June 1, 2007)
 PDF Word
Bulletin: Coding Updates
(July 22, 2005)
 PDF Word


114.3 CMR 51.00

Adult Foster Care
(May 1, 2008)
 PDF Word


114.3 CMR 52.00

Proposed Regulation
Rates of Payment for Certain Children's Behavioral Health Services
(November 1, 2008)
 PDF Word


 114.5 CMR 2.00

Disclosure of Hospital Case Mix and Charge Data
(November 15, 2006)
 PDF Word


 114.5 CMR 4.00

Rates for Certain Social, Rehabilitation,
and Health Care Consultant Services
(January 1, 1999)
 PDF Word


 114.5 CMR 9.00

Criteria and Procedures for Awarding One-time Grants
for Community Health Centers
(January 9, 2004)
 PDF Word


 114.5 CMR 10.00

Criteria and Procedures for Awarding One-time Grants
to Non-profit Providers of Elder Care Service
(March 15, 2001)
 PDF Word


 114.5 CMR 11.00

Criteria and Procedures for The Submission of
Health Plan Data
(April 8, 2005)
 PDF Word


 114.5 CMR 12.00

Nursing Facility User Fee
(July 1, 2006)
 PDF Word
Bulletin: Nursing Facility User Fee Update
(July 1, 2008)
 PDF Word
link to: Nursing Facilty Reports ---- ----
link to: DHCFP-INET Online Reporting System ---- ----


 114.5 CMR 14.00

Administration of Grants to Certain Community Health Centers
(June 3, 2003)
 PDF Word


 114.5 CMR 16.00

Determination of the Employer Fair Share Contribution
(Adopted October 1, 2008)
 PDFWord
Determination of the Employer Fair Share Contribution
(Effective October 1, 2006)
PDF Word
Executive Office of Labor and Workforce Development, includes an update on the Fair Share Contribution (FSC) Program and further information on and how it impacts employers.


114.5 CMR 17.00  

Employer Surcharge for State-funded Health Costs
(July 1, 2007)
 PDF Word
Commonwealth Connector, includes a key resources section highlighting the authority's final regulations and the "Employer Handbook," a downloadable brochure for employers concerning health care reform.


 114.5 CMR 18.00  

Health Insurance Responsibility Disclosure (HIRD)
(September 21, 2007)
 PDF Word
Employer HIRD Forms
Employee HIRD Form 


 114.6 CMR 3.00

Proposed Regulation:
Student Health Insurance
(October 1, 2008)
 PDF Word
Current Regulation:
Student Health Insurance
(August 1, 2006)
 PDF Word
Bulletin: Student Health Insurance Requirement for Students Enrolled only in Short-term Courses
(August 13, 2008) 
 PDF Word
Bulletin: Student Health Insurance Program Waiver Documentation Requirement
(July 1, 2008)
 PDF Word
link to: Student Health Insurance Information ---- ----


 114.6 CMR 13.00

Health Safety Net Eligible Services
(October 1, 2008)
 PDF Word
Bulletin: Health Safety Net Eligible Services Credit and Collection Policy Cross Reference Index
(October 1, 2008)
-- Cross Reference Index (PDF)Excel
 PDF Word
Bulletin: Deadline Extended for Submission of Acute Hospital and Community Health Center Credit and Collection Policies
(August 5, 2008)
 PDF Word
Bulletin: Refunding Health Safety Net Copayments for Medical Services
(July 7, 2008)
 PDF Word
Bulletin: Patient Copayment Effective Date Change
(December 11, 2007)
 PDF Word


 114.6 CMR 14.00

Health Safety Net Payments and Funding
(October 1, 2008)
 PDF Word

This information is provided by the Division of Health Care Finance and Policy.