MassHealth Therapy Telehealth Billing: POS and Modifiers

As of October 9, 2026. Start with All Provider Bulletin 379 and Managed Care Entity Bulletin 115 linked below. They set the state telehealth policy and managed-care coverage floor. Also check the actual service, clinician type and behavioral health administrator before choosing claim codes. All Provider Bulletin 379 telehealth policy Managed Care Entity Bulletin 115

When MassHealth covers therapy by telehealth

Bulletin 379 covers clinically appropriate, medically necessary, otherwise payable outpatient services delivered through video, audio-only or asynchronous modalities, subject to consent, licensure, program limits and its Appendix A. It provides payment parity with in-person counterparts. Coverage does not turn an unsupported service or provider type into a payable one. All Provider Bulletin 379 telehealth policy

Professional claim place of service and modifiers

• POS 10: the patient receives telehealth at home. POS 02: the patient is somewhere other than home. Use the patient’s actual location. All Provider Bulletin 379 telehealth policy

• Modifier 95: audio-video counseling and therapy. Modifier 93: audio-only services. Modifier FQ: audio-only counseling and therapy. All Provider Bulletin 379 telehealth policy

• The bulletin also lists FR for the specified real-time supervision and GQ for asynchronous services. Select applicable modifiers with the current service and administrator instructions; do not assume every audio-only claim requires the same modifier combination. All Provider Bulletin 379 telehealth policy

Use the correct service-code manual

MassHealth publishes separate LIBHC and Psychologist Manuals with service-code sections. Use the relevant manual along with the telehealth policy rather than replacing the underlying covered-service requirements with a modality modifier. LIBHC Manual Psychologist Manual

MBHP and managed-care billing checks

Bulletin 115 requires applicable managed-care entities, including the behavioral health vendor, to maintain coverage no more restrictive than Bulletin 379. It supersedes Bulletin 95 and remains effective until superseded. Confirm the plan’s actual claim instructions and contract; the bulletin is a coverage floor, not a shared claims portal. Managed Care Entity Bulletin 115

MBHP’s August 2026 presentation directs providers to its current benefit grid for telehealth billing requirements within the provider agreement. The grid does not establish which services a practice is contracted to provide. The August FAQ says other Carelon plan billing rules are contract and line-of-business specific. MBHP August 6, 2026 town hall MBHP August 6, 2026 town hall FAQ

Recommended pre-claim review

1. Confirm member and administrator. Check date-of-service eligibility and the behavioral health route. Ask whether authorization or a service-specific condition needs review.

2. Reconcile documentation and claim fields. Review the recorded modality, consent and patient location against the proposed POS and modifier. Ask the clinician to resolve missing information before choosing a code.

3. Use a current payer instruction. Save the applicable dated bulletin or plan instruction in your practice’s normal reference process. If instructions conflict, ask that administrator for clarification and document the answer.

Recheck policy when using an older billing guide

The official 2026 bulletin index was checked for this article’s source review. Revisit current bulletins and administrator updates when planning a new service or resolving a denial. A historical policy document should not be treated as a guarantee that every later claim configuration remains valid. Current 2026 MassHealth bulletin index

Related MassHealth guides

• MassHealth POSC Login: Provider Account Setup

• Add Your Biller to MassHealth POSC as a Subordinate User

• MassHealth Enrollment for LMHCs, LICSWs, LMFTs and Psychologists

• MassHealth ACOs, MCOs and MBHP: Behavioral Health Routing

• Verify MassHealth Eligibility with EVS, POSC or NEHEN

• MassHealth Behavioral Health Claims: POSC or MBHP

Get help with MassHealth billing setup

Bomi can help your therapy practice organize payer enrollment, portal permissions, eligibility checks and claims follow-up. The practice’s authorized administrator handles account permissions and approvals. See Bomi billing support.

Frequently Asked Questions

Which POS code is used when the patient is at home?

Bulletin 379 specifies POS 10 for professional telehealth claims when the patient is at home and POS 02 for other patient locations.

Can MassHealth cover audio-only therapy?

Bulletin 379 allows eligible services through audio-only telehealth when its clinical, consent, licensing and billing conditions are met.

Can I use one telehealth billing setup for every MassHealth plan?

Confirm the service and administrator’s claim instructions. Bulletin 115 sets a managed-care coverage floor, while manuals and contracts still govern the claim.

Sources

• All Provider Bulletin 379 telehealth policy

• Managed Care Entity Bulletin 115

• Current 2026 MassHealth bulletin index

• Psychologist Manual

• LIBHC Manual

• MBHP August 6, 2026 town hall

• MBHP August 6, 2026 town hall FAQ