# Mass. Gen. Laws ch. 176O, sec. 5D: Establishment of base fee schedule for evaluation and management services for behavioral health providers

> Massachusetts · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5D

## Section

- **Citation:** Mass. Gen. Laws ch. 176O, sec. 5D
- **Heading:** Establishment of base fee schedule for evaluation and management services for behavioral health providers
- **Jurisdiction:** Massachusetts
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** MA Code / Part I / Title XXII / Chapter 176O / Section 5D

## Text

Section 5D. For the purposes of this section, the term ''base fee schedule'' shall mean the minimum rates, typically set forth in fee schedules, paid by the carrier to an in-network health care provider who is not paid under an alternative payment arrangement for covered health care services; provided, however, that final rates may be subject to negotiations or adjustments that may result in payments to in-network providers that are different from the base fee schedule. A carrier, directly or through any entity that manages or administers mental health or substance use disorder benefits for the carrier, shall establish a base fee schedule for evaluation and management services for behavioral health providers that is not less than the base fee schedule used for evaluation and management services for primary care providers of the same or similar licensure type and in the same geographic region; provided, however, that a carrier shall not lower its base fee schedule for primary care providers to comply with this section. The division shall promulgate regulations to implement this section.

Section 5D. For the purposes of this section, the term ''base fee schedule'' shall mean the minimum rates, typically set forth in fee schedules, paid by the carrier to an in-network health care provider who is not paid under an alternative payment arrangement for covered health care services; provided, however, that final rates may be subject to negotiations or adjustments that may result in payments to in-network providers that are different from the base fee schedule.

A carrier, directly or through any entity that manages or administers mental health or substance use disorder benefits for the carrier, shall establish a base fee schedule for evaluation and management services for behavioral health providers that is not less than the base fee schedule used for evaluation and management services for primary care providers of the same or similar licensure type and in the same geographic region; provided, however, that a carrier shall not lower its base fee schedule for primary care providers to comply with this section.

The division shall promulgate regulations to implement this section.

## Nearby sections

- [Mass. Gen. Laws ch. 176O, sec. 1 Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S1.md)
- [Mass. Gen. Laws ch. 176O, sec. 2 Bureau of managed care](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S2.md)
- [Mass. Gen. Laws ch. 176O, sec. 3 Complaints against carriers; notice; hearing](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S3.md)
- [Mass. Gen. Laws ch. 176O, sec. 4 Refusal of carriers to contract with eligible health, dental or vision care providers solely because providers have practiced good faith advocacy on behalf of patients](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S4.md)
- [Mass. Gen. Laws ch. 176O, sec. 5 Contracts; liability](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5.md)
- [Mass. Gen. Laws ch. 176O, sec. 5A Acceptance and recognition of information submitted pursuant to current coding standards and guidelines required; use of standardized claim formats](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5A.md)
- [Mass. Gen. Laws ch. 176O, sec. 5B Policies and procedures to enforce Sec. 5A](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5B.md)
- [Mass. Gen. Laws ch. 176O, sec. 5C Failure of carrier to comply with coding standards and guidelines; notice; penalty](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5C.md)
- [Mass. Gen. Laws ch. 176O, sec. 5D Establishment of base fee schedule for evaluation and management services for behavioral health providers](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5D.md)
- [Mass. Gen. Laws ch. 176O, sec. 6 Evidence of coverage to be delivered to covered adults by health, dental and vision care providers; contents](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S6.md)
- [Mass. Gen. Laws ch. 176O, sec. 7 Information provided by carrier upon enrollment or upon request](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S7.md)
- [Mass. Gen. Laws ch. 176O, sec. 8 Failure by carrier to file annual statement; fine](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S8.md)
- [Mass. Gen. Laws ch. 176O, sec. 9 Utilization review programs; annual attestations](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S9.md)
- [Mass. Gen. Laws ch. 176O, sec. 9A Agreements or contracts between carrier and health care provider prohibited if containing certain provisions](https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S9A.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MA_PI_TXXII_C176O_S5D. Check the current official text before relying on it. Not legal advice.