Section 410.414 - Observation Services(A)Reimbursable Services. MassHealth covers medically necessary observation services provided by acute inpatient hospitals. Reimbursable observation services may exceed 24 hours, and do not need to be provided in a distinct observation unit. To qualify for reimbursement of observation services, the medical record must specifically document when those services began and ended, the purpose of observation, and the name of the physician who ordered it. Acute inpatient hospitals will be reimbursed for these observation services on an outpatient basis in accordance with the signed provider agreement with the MassHealth agency.(B)Nonreimbursable Services.(1) Nonreimbursable observation services include but are not limited to: (a) services that are not reasonable or necessary for the diagnosis or treatment of the member; and(b) routine preparation and recovery services associated with diagnostic testing or outpatient surgery.(2) The following services are not reimbursable as a separate service:(a) postoperative monitoring during a standard recovery period that should be characterized as recovery-room services; and(b) observation services provided concurrently with therapeutic services such as chemotherapy.Amended by Mass Register Issue 1344, eff. 7/28/2017.