Massachusetts H4894 amends laws to clarify and expand coverage for medically necessary mental health services.

Massachusetts H4894 amends existing laws to further define medical necessity determinations for mental health services. The bill mandates that health insurers and plans cover medically necessary mental health acute treatment, crisis stabilization services, and community-based acute treatment without requiring preauthorization. Medical necessity is determined by the treating clinician in consultation with the patient and must be noted in the patient’s medical record. Coverage extends to up to 14 days for crisis stabilization services and up to 21 days for community-based acute treatment.

Massachusetts H4894 amends laws to clarify and expand coverage for medically necessary mental health services.

Massachusetts H4894 amends existing laws to further define medical necessity determinations for mental health services. The bill mandates that health insurers and plans cover medically necessary mental health acute treatment, crisis stabilization services, and community-based acute treatment without requiring preauthorization. Medical necessity is determined by the treating clinician in consultation with the patient and must be noted in the patient’s medical record. Coverage extends to up to 14 days for crisis stabilization services and up to 21 days for community-based acute treatment.