- All Provider
- Abortion Clinic
- Acute Inpatient Hospital
- Acute Outpatient Hospital
- Adult Day Health
- Adult Foster Care
- Audiologist
- Chiropractor
- Chronic Disease and Rehabilitation Inpatient Hospital
- Chronic Disease and Rehabilitation Outpatient Hospital
- Community Health Center
- Day Habilitation Program
- Dental
- Diagnostic and Surgical Facility
- Durable Medical Equipment
- Family Planning Agency
- Freestanding Ambulatory Surgery Center
- Group Adult Foster Care
- Hearing Aid Dealer (See also Hearing Instrument Specialist)
- Hearing Instrument Specialist (See also Hearing Aid Dealer)
- Home Health Agency
- Hospice
- Independent Clinical Laboratory
- Long Term Care Facility
- Limited Services Clinic
- Managed Care Organization
- Municipally Based Health Services (See also School-Based Medicaid)
- Mental Health Center
- Nurse Midwife
- Nurse Practitioner
- Nursing Facility
- Oxygen
- Personal Care Attendant
- Pharmacy
- Physician
- Podiatrist
- Prescriber
- Primary Care Clinician
- Psychiatric Inpatient Hospital
- Psychiatric Outpatient Hospital
- Radiation Oncology Center
- Rehabilitation Center
- Renal Dialysis Clinic
- Rest Home
- School-Based Medicaid (See also Municipally Based Health Services)
- Speech and Hearing Center
- Sterilization Clinic
- Substance Abuse Treatment
- Therapist
- Transportation
- Vision Care
- Wig
All Provider
- All Provider Bulletin 225:
Special Circumstances for Electronic Claims
- All Provider Bulletin 224:
Provider Overpayment Disclosure Process
- All Provider Bulletin 223:
Changes to Electronic Claims Submission Policy
- All Provider Bulletin 222:
5010 Implementation Cutover
- All Provider Bulletin 221:
Revisions to the Final Deadline Appeal Procedures
- All Provider Bulletin 220:
Revisions to the 90-Day Waiver Procedures
- All Provider Bulletin 219a:
5010 Implementation Readiness - Corrected
This bulletin has been corrected to reflect a revised date on which the EVSpc software and installation instructions will be available. The new date is December 12, 2011. - All Provider Bulletin 218:
Service Animal Indication on the Prescription for Transportation (PT-1) Form
- All Provider Bulletin 217:
Waiver Policy for Claim Submissions (PDF)
- All Provider Bulletin 215:
Change in Pharmacy Copayments (PDF)
- All Provider Bulletin 215:
Change in Pharmacy Copayments (PDF)
- All Provider Bulletin 214:
New Address for Disability Supplements (PDF)
- All Provider Bulletin 213:
Testing Readiness for CMS 5010 Mandate (PDF)
- All Provider Bulletin 212:
Important Claims Submission Policy Changes (PDF)
- All Provider Bulletin 211:
Critical Edit for Required Behavioral Health Screen Modifier (PDF)
- All Provider Bulletin 210:
5010 Implementation Preparation (PDF)
- All Provider Bulletin 209:
Medicaid National Correct Coding Initiative (PDF)
- All Provider Bulletin 208:
Overview of Key Changes to Be Implemented on January 1, 2012, to Support the Centers for Medicare & Medicaid Services 5010 Mandate (PDF)
- All Provider Bulletin 207:
Reduction of Paper Claim Forms (PDF)
- All Provider Bulletin 206:
Medicaid Hospice Benefit for Children and Concurrent Curative Treatment (PDF)
- All Provider Bulletin 205:
Implementation Approach for HIPAA X12 5010 Electronic Transactions (PDF)
- All Provider Bulletin 204:
Revised Billing Instructions for Healthy Start Program (HSP) Providers (PDF)
- All Provider Bulletin 203:
Centers for Medicare & Medicaid Services (CMS) FY2010 Payment Error Rate Measurement (PERM) Project (PDF)
- All Provider Bulletin 202:
Credit Balance Overpayment Policy (PDF)
- All Provider Bulletin 201:
New Carrier Code Request Form (PDF)
- All Provider Bulletin 200:
Federal Medicaid Integrity Program Provider Audits (PDF)
- All Provider Bulletin 199:
Elimination of Full Paper Mailing of Bulletins and Transmittal Letters (PDF)
- All Provider Bulletin 198:
Password Expiration and Reset for EVSpc (PDF)
- All Provider Bulletin 197:
Coverage of H1N1 and Seasonal Influenza Vaccinations (PDF)
- All Provider Bulletin 196:
Provider Obligation to Screen Employees and Contractors for Exclusion from Participation in Federal Health Care Programs (PDF)
- All Provider Bulletin 195:
Changes for Access to Behavioral-Health Services for Certain MassHealth Members (PDF)
- All Provider Bulletin 194:
Primary Care Clinician (PCC) Referral Process (PDF)
- All Provider Bulletin 193:
Copies of PDF Remittance Advice (PDF)
- All Provider Bulletin 192:
Revised Prescription for Transportation (PT-1) Form (PDF)
- All Provider Bulletin 191:
New MassHealth Member ID Card (PDF)
- All Provider Bulletin 190:
Preadmission Screening (PAS-A and PAS-CR) Forms (PDF)
- All Provider Bulletin 189:
Prior Authorization (PA-1) Form (PDF)
- All Provider Bulletin 188:
Elimination of the PCC Plan Referral Requirement for Certain Services (PDF)
- All Provider Bulletin 187:
NewMMIS Implementation Schedule (PDF)
- All Provider Bulletin 186:
Final Deadline Appeal Procedures (PDF)
- All Provider Bulletin 185:
NewMMIS Preparation, E-Learning, Trading Partner Testing, and NPI Readiness (PDF)
- All Provider Bulletin 184:
NewMMIS Member Eligibility Verification System and Discontinuation of Eligibility Operator (PDF)
- All Provider Bulletin 183:
Member Eligibility REVS Responses Provided Between 12/17/08 and 01/13/09 (PDF)
- All Provider Bulletin 182:
Important Updates about NewMMIS (PDF)
- All Provider Bulletin 181:
NewMMIS Important Events and Activities Scheduled for November (PDF)
- All Provider Bulletin 180:
Tamper-Resistant Prescription Update (PDF)
- All Provider Bulletin 179:
90-Day Waiver Request and New 90-Day Waiver Request Form (PDF)
- All Provider Bulletin 178:
Point-of-Service (POS) Device Termination (PDF)
- All Provider Bulletin 177:
Rescheduling of NewMMIS Implementation and Preparation Activities (PDF)
All Provider Bulletin 176: New MassHealth Card (PDF)
All Provider Bulletin 175: NewMMIS Service Authorization, Eligibility Verification, and Claims Status Inquiry (PDF)
- All Provider Bulletin 174:
Massachusetts Implementation of Tamper-Resistant Prescription Requirements (PDF)
- All Provider Bulletin 173:
NewMMIS Implementation Schedule for Member, Provider, and Claims Functions (PDF)
- All Provider Bulletin 172:
NewMMIS Key Concepts and Provider Preparation Guidelines (PDF)
- All Provider Bulletin 171:
Credit Balance Overpayment Policy (PDF)
- All Provider Bulletin 170:
A New Medicaid Management Information System Is Coming (PDF)
- All Provider Bulletin 169:
Ordering MassHealth's Wellness Program Member Brochure (PDF)
- All Provider Bulletin 168:
Six-Month Delay for the Requirement for Tamper-Resistant, Written Prescriptions (PDF)
- All Provider Bulletin 167:
Requirement for Tamper-Resistant, Written Prescriptions (PDF)
- All Provider Bulletin 166:
CMS Payment Error Rate Measurement Project (PERM) (PDF)
- All Provider Bulletin 165:
MassHealth's Wellness Program Member Brochure (PDF)
- All Provider Bulletin 164:
Implementation of National Provider Identifier (NPI) Number (PDF)
- All Provider Bulletin 163:
New Look for WebREVS (PDF)
- All Provider Bulletin 162:
Employee Education about False Claims (PDF)
- All Provider Bulletin 161:
Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services for MassHealth Members Under Age 21 with CommonHealth Coverage (PDF)
- All Provider Bulletin 160:
MassHealth Provider Recredentialing (PDF)
- All Provider Bulletin 159:
Managed Care Enhancements on REVS (PDF)
- All Provider Bulletin 158:
Coordination of Benefits for Crossover Claims (PDF)
- All Provider Bulletin 157:
Requesting Nonemergency Transportation for a Member Online (PDF)
- All Provider Bulletin 156:
Downloading and Ordering Forms and Other MassHealth Publications Online (PDF)
- All Provider Bulletin 155:
Expansion of Services for Adult MassHealth Members and Tobacco Cessation Services for Members of All Ages (PDF)
- All Provider Bulletin 154:
Enhanced REVS Capabilities (PDF)
- All Provider Bulletin 153:
Preferred Communication Method Options (PDF)
- All Provider Bulletin 152:
Void Request Form for Non-Pharmacy Claims (PDF)
- All Provider Bulletin 151:
Enhancements to WebREVS (PDF)
- All Provider Bulletin 150:
Redesigned MassHealth Card (PDF)
- All Provider Bulletin 149:
Elimination of the MassHealth Secure File Delivery Application (PDF)
- All Provider Bulletin 148:
Expanded REVS Eligibility History (PDF)
file size 4MB
- All Provider Bulletin 147:
Policy Regarding MCO Claims Submission (PDF)
- All Provider Bulletin 146:
Update on Expanded MassHealth Customer Service (PDF)
file size 4MB
- All Provider Bulletin 145:
National Provider Identifiers (PDF)
file size 4MB
- All Provider Bulletin 144:
Expanded Customer Services for MassHealth Providers and Members (PDF)
file size 8MB
- All Provider Bulletin 143:
A New Way to Communicate with Providers (PDF)
file size 3MB
- All Provider Bulletin 142:
Guidelines for Medical Necessity Determination for Certain Products and Services (PDF)
file size 4MB
- All Provider Bulletin 141:
Revised Prescription for Transportation (PT-1) Form on Web Site (PDF)
file size 4MB
- All Provider Bulletin 140:
Integration of the MassHealth Provider Services Web Site into Mass.Gov Portal (PDF)
file size 4MB
- All Provider Bulletin 139:
Implementation of a HIPAA-Compliant Secure File Delivery Application (PDF)
file size 4MB
- All Provider Bulletin 138:
Credit Balance Overpayment Policy (PDF)
file size 3MB
- All Provider Bulletin 137:
New MassHealth Web Site (PDF)
file size 3MB
- All Provider Bulletin 136:
Claims Processing and HIPAA Compliance for Electronic Claims Transactions (PDF)
file size 5MB
- All Provider Bulletin 135:
New Massachusetts Management and Accounting Reporting System (NewMMARS) (PDF)
file size 3MB
- All Provider Bulletin 134:
Billing Deadline for MassHealth Claims (PDF)
file size 2MB
- All Provider Bulletin 133:
HIPAA Compliance for Electronic Claims Transactions (PDF)
file size 4MB
- All Provider Bulletin 132:
HIPAA Compliance for Electronic Claims Transactions (PDF)
file size 3MB
- All Provider Bulletin 131:
Revision to MassHealth Breast and Cervical Cancer Treatment Program (PDF)
file size 3MB
- All Provider Bulletin 130:
Change in MassHealth Co-payment Policy (PDF)
- All Provider Bulletin 129:
MassHealth Breast and Cervical Cancer Treatment Program (PDF)
- All Provider Bulletin 128:
Implementation of the HIPAA-Compliant Electronic Prior Authorization Request and Response Transaction (PDF)
- All Provider Bulletin 127:
Implementation of HIPAA-Compliant Electronic Remittance Advice (PDF)
- All Provider Bulletin 126:
HIPAA Compliance for Electronic Claim Submissions (PDF)
- All Provider Bulletin 125:
Billing Procedure for HIPAA Electronic Claims Requiring Attachments (PDF)
- All Provider Bulletin 124:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
- All Provider Bulletin 123:
New Rebilling Procedures for Denied Claims (PDF)
- All Provider Bulletin 122:
Administrative Simplification: Remittance Advices (PDF)
- All Provider Bulletin 121:
Updated Appendix C and New Carrier Code (PDF)
- All Provider Bulletin 120:
Important Information about the MassHealth Pharmacy Program (PDF)
- All Provider Bulletin 119:
Modification to REVS Automated Voice Response (AVR) System (PDF)
- All Provider Bulletin 118:
Changes to MassHealth Basic and Buy-in Eligibility Rules (PDF)
- All Provider Bulletin 117:
New Options for Claim Status Requests (PDF)
- All Provider Bulletin 116:
HIPAA Eligibility and Response Transaction 270/271 (PDF)
- All Provider Bulletin 115:
MassHealth Drug List (PDF)
file size 1MB
- All Provider Bulletin 114:
Payment for the Medicare Part B Crossover Claims Repricing (PDF)
- All Provider Bulletin 113:
Division of Medical Assistance Web Site (PDF)
- All Provider Bulletin 112:
Overpayment Policy (PDF)
- All Provider Bulletin 111:
Redesigned MassHealth Card (PDF)
- All Provider Bulletin 110:
Medicare Part B Crossover Claims Update (PDF)
- All Provider Bulletin 109:
Billing Deadline for MassHealth Claims (PDF)
- All Provider Bulletin 108:
Medicare Part B Crossover Claim Update (PDF)
- All Provider Bulletin 107:
Year-2000 Update (PDF)
- All Provider Bulletin 106:
Billing for Missed Appointments (PDF)
- All Provider Bulletin 105:
Year 2000 (Readiness Disclosure Notice) (PDF)
- All Provider Bulletin 104:
Payment for the Medicare Part B Coinsurance and Deductible (PDF)
Abortion Clinic
- Abortion Clinic Bulletin 8:
Elimination of Global Billing for Services with a Professional and a Technical Component (PDF)
file size 5MB
- Abortion Clinic Bulletin 7:
Administrative Simplification for Claims Requiring Attachments (PDF)
Acute Inpatient Hospital
- Acute Inpatient Hospital Bulletin 143:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Acute Inpatient Hospital Bulletin 142:
Revisions to the Medical Benefit Request, the Senior Medical Benefit Request, Other Forms, and the Virtual Gateway
- Acute Inpatient Hospital Bulletin 141:
Address Change for the Notification of Birth (NOB-1) Form
- Acute Inpatient Hospital Bulletin 140:
Revisions to the Medical Benefit Request, the Senior Medical Benefit Request, and the Virtual Gateway (PDF)
- Acute Inpatient Hospital Bulletin 139:
Revised Notification of Birth (NOB-1) Form (PDF)
- Acute Inpatient Hospital Bulletin 138:
Revised Medical Benefit Request Form (PDF)
- Acute Inpatient Hospital Bulletin 137:
Preadmission Screening and Postpayment Review (PDF)
- Acute Inpatient Hospital Bulletin 136:
Revised Notification of Birth (NOB-1) Form (PDF)
- Acute Inpatient Hospital Bulletin 135:
Revised Medical Benefit Request and Senior Medical Benefit Request Forms (PDF)
- Acute Inpatient Hospital Bulletin 134:
Revised Medical Benefit Request Form (PDF)
- Acute Inpatient Hospital Bulletin 133:
Revised Notification of Birth (NOB-1) Form (PDF)
- Acute Inpatient Hospital Bulletin 132:
Revision to the Notification of Clinical Eligibility for Nursing Facility Services (PDF)
- Acute Inpatient Hospital Bulletin 131:
Changes in REVS Display for Uncompensated Care Pool (UCP) Patients (PDF)
- Acute Inpatient Hospital Bulletin 130:
Guideline for Medical Necessity Determination for Breast Reduction (PDF)
file size 3MB
- Acute Inpatient Hospital Bulletin 129:
Revised Notification of Birth (NOB-1) Form (PDF)
- Acute Inpatient Hospital Bulletin 128:
Revisions to the Nursing Facility Preadmission Process (PDF)
file size 4MB
- Acute Inpatient Hospital Bulletin 127:
Billing for Physician Services with a Professional and a Technical Component (PDF)
file size 3MB
- Acute Inpatient Hospital Bulletin 126:
Electronic Claim Submissions for Dually Eligible Members (PDF)
- Acute Inpatient Hospital Bulletin 125:
Administrative Simplification for Claims Requiring Attachments (PDF)
- Acute Inpatient Hospital Bulletin 124:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
- Acute Inpatient Hospital Bulletin 123:
MassHealth Eligibility Representative Designation MassHealth Permission to Share Information (PDF)
- Acute Inpatient Hospital Bulletin 122:
Changes in Clinical Assessment Forms (PDF)
- Acute Inpatient Hospital Bulletin 121:
Relocation of Notification of Birth (NOB) Unit
- Acute Inpatient Hospital Bulletin 120:
Move of Central Processing Unit to Charlestown (PDF)
- Acute Inpatient Hospital Bulletin 119:
Babies Born to Women on MassHealth Limited (PDF)
- Acute Inpatient Hospital Bulletin 118:
Rebilling Denied Inpatient Admissions as Outpatient Services (PDF)
- Acute Inpatient Hospital Bulletin 117:
Revised Medical Benefit Request (PDF)
- Acute Inpatient Hospital Bulletin 116:
Clinical Review of Inpatient Claims (PDF)
- Acute Inpatient Hospital Bulletin 115:
Revisions to the Notification of Clinical Eligibility for Nursing Facility Services (PDF)
- Acute Inpatient Hospital Bulletin 114:
Changes to the Notification of Birth (NOB-1) Form (PDF)
Acute Outpatient Hospital
- Acute Outpatient Hospital Bulletin 24:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Acute Outpatient Hospital Bulletin 23:
Updated Drug Screen Testing Unit Limitation (PDF)
- Acute Outpatient Hospital Bulletin 22:
Reporting National Drug Code (NDC) Information for Physician-Administered Drugs by Outpatient Hospitals, Hospital-Licensed Health Centers (HLHCs), and Other Satellite Facilities (PDF)
- Acute Outpatient Hospital Bulletin 21:
Maximum Units Payable (PDF)
- Acute Outpatient Hospital Bulletin 20:
Medical Nutrition Therapy and Diabetes Self Management Training (PDF)
- Acute Outpatient Hospital Bulletin 19:
Return of Overpayments - Medicare Crossover Claims for Outpatient Hospital Services (PDF)
file size 4MB
- Acute Outpatient Hospital Bulletin 18:
Dental Services Exempted From the Physical Presence Requirement (PDF)
file size 4MB
- Acute Outpatient Hospital Bulletin 17:
Correction for MassHealth Tobacco Cessation Counseling Benefit Chart (PDF)
- Acute Outpatient Hospital Bulletin 16:
Emergency Department Charges for Certain Behavioral Health Services (PDF)
- Acute Outpatient Hospital Bulletin 15:
Admission Hour Required on All Acute Outpatient Hospital Claims (PDF)
- Acute Outpatient Hospital Bulletin 14:
2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Acute Outpatient Hospital Bulletin 13:
Guideline for Medical Necessity Determination for Breast Reduction (PDF)
file size 3MB
- Acute Outpatient Hospital Bulletin 12:
2005 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Acute Outpatient Hospital Bulletin 11:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 5MB
- Acute Outpatient Hospital Bulletin 10:
Administrative Simplification for Claims Requiring Attachments (PDF)
- Acute Outpatient Hospital Bulletin 9:
Updates to Payable and Nonpayable Services Provided to MassHealth Members (PDF)
- Acute Outpatient Hospital Bulletin 8:
Maxium Billable Units on Revenue Codes and Current Procedural Terminology Codes (CPT4) (PDF)
- Acute Outpatient Hospital Bulletin 7:
Revisions to Service and Revenue Codes (PDF)
- Acute Outpatient Hospital Bulletin 6:
HCFA Common Procedure Coding System (HCPCS) Update (PDF)
- Acute Outpatient Hospital Bulletin 5:
HCFA Common Procedure Coding System (HCPCS) Update (PDF)
- Acute Outpatient Hospital Bulletin 4:
Maxium Billable Units for Certain Services Provided by Acute Outpatient Hospitals (PDF)
- Acute Outpatient Hospital Bulletin 3:
HCFA Common Procedure Coding System (HCPCS) Update
- Acute Outpatient Hospital Bulletin 2:
Rebilling Denied Inpatient Admissions as Outpatient Services (PDF)
- Acute Outpatient Hospital Bulletin 1:
Billing for Chemotherapy Services and Drugs (PDF)
Adult Day Health
- Adult Day Health Bulletin 13:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Adult Day Health Bulletin 12:
MassHealth Community Services Critical Incident Report Form
- Adult Day Health Bulletin 11:
Clinical Assessment Requirements for MassHealth Members in Adult Day Health Programs (PDF)
- Adult Day Health Bulletin 10:
Changes in Clinical Assessment for Adult Day Health Services (PDF)
- Adult Day Health Bulletin 9:
Reimbursement for Dementia Day-Care Services (PDF)
Adult Foster Care
- Adult Foster Care Bulletin 9:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Adult Foster Care Bulletin 8:
MassHealth Community Services Critical Incident Report Form
- Adult Foster Care Bulletin 6:
Changes in Clinical Assessment for Adult Foster Care Services (PDF)
Audiologist
- Audiologist Bulletin 4:
Revised Billing Procedures for Certain Hearing Aid Services and Miscellaneous Billing Reminders (PDF)
- Audiologist Bulletin 3:
2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Audiologist Bulletin 2:
Revisions to Service Limits on Office Visits for Evaluation and Management Services (PDF)
file size 3MB
- Audiologist Bulletin 1:
Conditions of Payment for the Dispensing of Hearing Aids (PDF)
Chiropractor
- Chiropractor Bulletin 4:
Billing for Physician Services with a Professional and a Technical Component (PDF)
file size 3MB
- Chiropractor Bulletin 3:
Chiropractic Services to Members Enrolled in MassHealth Managed Care Organizations (PDF)
Chronic Disease and Rehabilitation Inpatient Hospital
- Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 87:
Dental Services Exempted From the Physical Presence Requirement (PDF)
file size 4MB
- Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 86:
Revisions to the Nursing Facility Preadmission Process (PDF)
file size 4MB
- Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 85:
Electronic Claim Submissions for Members with Medicare and Commercial Insurance (PDF)
- Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 84:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
- Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 83:
Changes in Clinical Assessment Forms (PDF)
file size 1MB
- Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 82:
Inpatient Claims Submission for Dually Entitled Members (PDF)
Chronic Disease and Rehabilitation Outpatient Hospital
- Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 4:
Reporting National Drug Code (NDC) Information for Physician-Administered Drugs by Chronic Disease and Rehabilitation Outpatient Hospitals (PDF)
- Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 3:
New Service Code to Claim and Report Behavioral Health (Mental Health and Substance Abuse) Screenings for MassHealth Members Under the Age of 21 Years (PDF)
- Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 2:
Admission Hour Required on All Chronic Disease and Rehabilitation Outpatient Hospital Claims (PDF)
- Chronic Disease and Rehabilitation Outpatient Hospital Bulletin 1:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 4MB
Community Health Center
- Community Health Center Bulletin 70:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Community Health Center Bulletin 69:
Updates to the National Drug Code Requirements for Physician-Administered Medications
- Community Health Center Bulletin 68:
Revisions to the Medical Benefit Request, the Senior Medical Benefit Request, Other Forms, and the Virtual Gateway
- Community Health Center Bulletin 67:
Revisions to the Medical Benefit Request, the Senior Medical Benefit Request, and the Virtual Gateway (PDF)
- Community Health Center Bulletin 66:
Updated Drug Screen Testing Unit Limitation (PDF)
- Community Health Center Bulletin 65:
Revised Medical Benefit Request Form (PDF)
- Community Health Center Bulletin 64:
Clarification of Coverage of Formulas (Enteral-Nutrition Products)
- Community Health Center Bulletin 63:
Revised Medical Benefit Request and Senior Medical Benefit Request Forms (PDF)
- Community Health Center Bulletin 62:
Clarification of Coverage of Formulas (Enteral-Nutrition Products) (PDF)
- Community Health Center Bulletin 61:
Revised Medical Benefit Request Form (PDF)
- Community Health Center Bulletin 60:
Medical Nutrition Therapy and Diabetes Self-Management Training (PDF)
- Community Health Center Bulletin 59:
Correction for MassHealth Tobacco Cessation Counseling Benefit Chart (PDF)
- Community Health Center Bulletin 58:
2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Community Health Center Bulletin 57:
Changes in REVS Display for Uncompensated Care Pool (UCP) Patients (PDF)
- Community Health Center Bulletin 56:
Guideline for Medical Necessity Determination for Breast Reduction (PDF)
file size 3MB
- Community Health Center Bulletin 55:
340B Drug-Pricing Program for MassHealth Members (PDF)
file size 4MB
- Community Health Center Bulletin 54:
Billing for Physician Services with a Professional and a Technical Component (PDF)
file size 3MB
- Community Health Center Bulletin 53:
Services Provided by a Medicare-Noncertified Clinician (PDF)
- Community Health Center Bulletin 52:
Controlled Substances Management Program (PDF)
- Community Health Center Bulletin 51:
MassHealth Eligibility Representative Designation MassHealth Permission to Share Information (PDF)
- Community Health Center Bulletin 50:
Revisions to the MassHealth Dental Program (PDF)
- Community Health Center Bulletin 49:
Move of Central Processing Unit to Charlestown (PDF)
- Community Health Center Bulletin 48:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
- Community Health Center Bulletin 47:
HCFA Common Procedure Coding System (HCPCS) Update (PDF)
- Community Health Center Bulletin 46:
Injectable and Infusible Drugs and Devices (PDF)
- Community Health Center Bulletin 45:
Revised Medical Benefit Request (PDF)
- Community Health Center Bulletin 44:
Obtaining Prior Authorization and Submitting Claims for Synagis (Palivizumab) (PDF)
- Community Health Center Bulletin 43:
New Address for Prior Authorization Requests for Drugs (PDF)
- Community Health Center Bulletin 42:
Prior Authorization for Celebrex in Dosages of 200 mg or More (PDF)
- Community Health Center Bulletin 41:
Prior Authorization for Enbrel, Herceptin and Remicade (PDF)
Day Habilitation Program
- Day Habilitation Program Bulletin 8:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Day Habilitation Program Bulletin 7:
MassHealth Community Services Critical Incident Report Form
- Day Habilitation Program Bulletin 6:
Reporting Requirements (PDF)
- Day Habilitation Program Bulletin 5:
Nursing Responsibilities, Documentation Requirements, and Coordination of Specialized Services (PDF)
- Day Habilitation Program Bulletin 4B:
Coordination of Specialized Services (PDF)
- Day Habilitation Program Bulletin 4A:
Clarification of Day Habilitation Providers' Responsibilities (PDF)
- Day Habilitation Program Bulletin 3:
Rate Increase and Staffing Criteria for Day Habilitation Services Provided to Nursing Facility Residents (PDF)
- Day Habilitation Program Bulletin 2B:
Supplemental Staffing (PDF)
- Day Habilitation Program Bulletin 2A:
Day Habilitation Service in Nursing Facilities (PDF)
Dental
- Dental Bulletin 41:
NewMMIS Preparation and Billing Changes for Oral and Maxillofacial Surgeons (PDF)
- Dental Bulletin 40:
NewMMIS Preparation Activities and Rescheduling of NewMMIS Implementation (PDF)
- Dental Bulletin 39:
MassHealth-Contracted Managed Care Organizations (MCOs) Covered Dental Services (PDF)
- Dental Bulletin 38:
Clarification of Dental Policy for Covered Services and Conditions of Payment (PDF)
- Dental Bulletin 37:
New Start Date for Dental Third-Party Administrator (TPA) - February 1, 2007 (PDF)
- Dental Bulletin 36:
New Dental Third-Party Administrator for MassHealth Providers and Members (PDF)
- Dental Bulletin 35:
American Dental Association (ADA) Claim Form for Paper MassHealth Claims, Changes to Remittance Advices for Paper Claims, and Billing Instructions (PDF)
- Dental Bulletin 34:
American Dental Association (ADA) Claim Form for Paper MassHealth Claims, Changes to Remittance Advices for Paper Claims, and Billing Instructions (PDF)
- Dental Bulletin 33:
Coverage of Comprehensive Dental Benefits for Pregnant Women and for Mothers with Children Under the Age of Three Years (PDF)
- Dental Bulletin 32:
2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Dental Bulletin 31:
Billing for Physician Services with a Professional and a Technical Component (PDF)
file size 3MB
- Dental Bulletin 30:
Supplemental Dental Prior Authorization Form (PDF)
- Dental Bulletin 29:
Controlled Substances Management Program (PDF)
- Dental Bulletin 28:
Implementation of HIPAA-Compliant Electronic Claim Format (PDF)
- Dental Bulletin 27:
Patient-Paid-Amount (PPA) Adjustment for Residents of Long-Term-Care Facilities for Adult Dental Expenses Not Covered by MassHealth as of March 15,2002 (PDF)
- Dental Bulletin 26:
Important Information About Special Circumstances and Dental Group Practices (PDF)
- Dental Bulletin 25:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
- Dental Bulletin 24:
New Address for Prior Authorization Requests for Drugs (PDF)
- Dental Bulletin 23:
Oral Surgery and MassHealth-Contracted Managed Care Organizations, including MassHealth-Contracted Health Maintenance Organizations (HMOs) (PDF)
Diagnostic and Surgical Facility
- Diagnostic and Surgical Facility Bulletin 8:
Revised List of Service Codes and Descriptions (2003 HCPCS) (PDF)
- Diagnostic and Surgical Facility Bulletin 7:
Revised List of Service Codes and Description (2001 and 2002 HCPCS) (PDF)
- Diagnostic and Surgical Facility Bulletin 6:
HCFA Common Procedure Coding System (HCPCS) Update (PDF)
- Diagnostic and Surgical Facility Bulletin 5:
Revised List of Service Codes and Descriptions (1999 and 2000 HCPCs) (PDF)
Durable Medical Equipment
- Durable Medical Equipment Bulletin 17:
Guidelines for Medical Necessity Determination for Hospital Beds and Prescription and Medical Necessity Review Form for Hospital Beds (PDF)
- Durable Medical Equipment Bulletin 16:
Clarification of Coverage of Formulas (Enteral-Nutrition Products)
- Durable Medical Equipment Bulletin 15:
Personal Emergency Response Systems (PERS): New Monthly Rental Rate, Prior Authorization, Documentation, and Installation Requirements (PDF)
- Durable Medical Equipment Bulletin 14:
Clarification of Coverage of Formulas (Enteral-Nutrition Products) (PDF)
- Durable Medical Equipment Bulletin 13:
New General Prescription Form (PDF)
Family Planning Agency
- Family Planning Agency Bulletin 11:
Updates to the National Drug Code Requirements for Physician-Administered Medications
- Family Planning Agency Bulletin 10:
Billing for Physician Services with a Professional and a Technical Component (PDF)
file size 3MB
- Family Planning Agency Bulletin 9:
Administrative Simplification for Claims Requiring Attachments (PDF)
Freestanding Ambulatory Surgery Center
- Freestanding Ambulatory Surgery Center Bulletin 3:
Administrative Simplification for Claims Requiring Attachments (PDF)
Group Adult Foster Care
- Group Adult Foster Care Bulletin 5:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Group Adult Foster Care Bulletin 4:
MassHealth Community Services Critical Incident Report Form
- Group Adult Foster Care Bulletin 3:
Change in Group Adult Foster Care Provider Rates
- Group Adult Foster Care Bulletin 2:
Changes in Clinical Assessment for Group Adult Foster Care Services (PDF)
- Group Adult Foster Care Bulletin 1:
Revised Service Codes (PDF)
Hearing Aid Dealer (See also Hearing Instrument Specialist)
- Hearing Aid Dealer Bulletin 9:
Conditions of Payment for the Dispensing of Hearing Aids (PDF)
- Hearing Aid Dealer Bulletin 8:
Hearing Aid Services for Members Enrolled in MassHealth Managed Care Organizations (PDF)
Hearing Instrument Specialist (See also Hearing Aid Dealer)
- Hearing Instrument Specialist Bulletin 12:
Revised Billing Procedures for Certain Hearing Aid Services and Miscellaneous Billing Reminders (PDF)
- Hearing Instrument Specialist Bulletin 11:
2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Hearing Instrument Specialist Bulletin 10:
Revisions to Service Limits on Office Visits for Evaluation and Management Services (PDF)
file size 3MB
Home Health Agency
- Home Health Agency Bulletin 47:
Coverage of Seasonal Influenza Vaccinations
- Home Health Agency Bulletin 46:
New Home Health Coverage Determination Form (PDF)
- Home Health Agency Bulletin 45:
Changes in Screening Procedures for Members Aged 60 or Older (PDF)
- Home Health Agency Bulletin 44:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 4MB
- Home Health Agency Bulletin 43:
Delay in Implementation of New Prior Authorization Policy for Certain Therapy Services (PDF)
file size 3MB
- Home Health Agency Bulletin 42:
Correction to Transmittal Letter HHA-35 (PDF)
file size 4MB
- Home Health Agency Bulletin 41:
Electronic Claim Submissions for Members with Medicare and Commercial Insurance (PDF)
- Home Health Agency Bulletin 40:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
- Home Health Agency Bulletin 39:
Submitting Claims to MassHealth Based on Physicians' Verbal Orders
- Home Health Agency Bulletin 38:
Revised MassHealth Reporting Form for Continuous Skilled Nursing
- Home Health Agency Bulletin 37:
Suspension of Home and Health Agency Bulletin 36 (PDF)
TEXT
- Home Health Agency Bulletin 36:
Behavioral Health Services (PDF)
- Home Health Agency Bulletin 35:
Changes in the Prior Authorization Process for Private-Suty Nursing Services (PDF)
- Home Health Agency Bulletin 34:
Temporary Emergency Personal Care Attendant (PCA) Services Plan (PDF)
Hospice
- Hospice Bulletin 9:
Changes to MassHealth Policy about the Provision of MassHealth Personal Care Attendant (PCA) Services to Hospice Members (PDF)
- Hospice Bulletin 8:
Changes to the MassHealth Hospice Form (PDF)
- Hospice Bulletin 7:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
Independent Clinical Laboratory
- Independent Clinical Laboratory Bulletin 8:
Updated Drug Screen Testing Unit Limitation (PDF)
- Independent Clinical Laboratory Bulletin 7:
Billing for Physician Services with a Professional and a Technical Component (PDF)
file size 3MB
- Independent Clinical Laboratory Bulletin 6:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
Long Term Care Facility
- Long Term Care Facility Bulletin 105:
Address and Fax Number Changes for Submitting MassHealth Long-Term-Care Eligibility Paperwork for New Applicants and Existing Members (PDF)
- Long Term Care Facility Bulletin 104:
2011 Annual Accounting for Personal Needs Account Funds (PDF)
- Long Term Care Facility Bulletin 103:
Change of Address for Taunton MassHealth Enrollment Center Long-Term-Care Applications(PDF)
- Long Term Care Facility Bulletin 102:
Patient-Paid-Amount Adjustments for MassHealth Members in Nursing Facilities, Chronic Disease and Rehabilitation Inpatient Hospitals, and Psychiatric Inpatient Hospitals, Including Adjustments for Adult Dental Expenses Not Covered by MassHealth as of July 1, 2010 (PDF)
- Long Term Care Facility Bulletin 101:
2010 Annual Accounting for Personal Needs Account Funds (PDF)
- Long Term Care Facility Bulletin 100:
Annual Accounting for Personal Needs Account Funds (PDF)
- Long Term Care Facility Bulletin 99:
Revised Status Change for Members in a Nursing Facility or Chronic Disease and Rehabilitation Inpatient Hospital (SC-1) Form (PDF)
- Long Term Care Facility Bulletin 98:
Annual Accounting for Personal Needs Account Funds (PDF)
- Long Term Care Facility Bulletin 97:
MassHealth and the Federal Economic Stimulus Tax Rebates (PDF)
- Long Term Care Facility Bulletin 96:
Increase in Personal Needs Allowance (PDF)
- Long Term Care Facility Bulletin 95:
Annual Accounting for Personal Needs Account Funds (PDF)
- Long Term Care Facility Bulletin 94:
2007 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Long-Term-Care Facilities (PDF)
- Long Term Care Facility Bulletin 93:
Deficit Reduction Act of 2005: Long-Term-Care Eligibility Changes (PDF)
- Long Term Care Facility Bulletin 92:
2006 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Long-Term-Care Facilities (PDF)
- Long Term Care Facility Bulletin 91:
Annual Accounting for Personal Needs Allowance Funds (PDF)
- Long Term Care Facility Bulletin 90:
Annual Accounting for Personal Needs Allowance Funds (PDF)
file size 5MB
- Long Term Care Facility Bulletin 89:
Senior Medical Benefit Request (SMBR) (PDF)
file size 4MB
- Long Term Care Facility Bulletin 88:
2005 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Long-Term-Care Facilities (PDF)
file size 4MB
- Long Term Care Facility Bulletin 87:
Annual Accounting for Personal Needs Allowance Funds (PDF)
file size 4MB
- Long Term Care Facility Bulletin 86:
2004 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Long-Term-Care Facilities (PDF)
file size 3MB
- Long Term Care Facility Bulletin 85:
MassHealth Eligibility Representative Designation MassHealth Permission to Share Information (PDF)
- Long Term Care Facility Bulletin 84:
Annual Accounting for Personal Needs Allowance Funds (PDF)
- Long Term Care Facility Bulletin 83:
Medex Premium Rate Increase (PDF)
- Long Term Care Facility Bulletin 82:
2003 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Long-Term-Care Facilities (PDF)
- Long Term Care Facility Bulletin 81:
New and Revised MassHealth Application Packets and Eligibility Review Materials for Seniors and People Needing Long-Term-Care Services (PDF)
- Long Term Care Facility Bulletin 80:
Patient-Paid-Amount (PPA) Adjustment for Residents of Long-Term-Care Facilities for Adult Dental Expenses Not Covered by MassHealth as of March 15,2002 (PDF)
- Long Term Care Facility Bulletin 79:
Annual Accounting for Personal Needs Allowance Funds (PDF)
- Long Term Care Facility Bulletin 78:
Medex Premium Rate Increase (PDF)
- Long Term Care Facility Bulletin 77:
2002 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Skilled-Care Facilities (PDF)
- Long Term Care Facility Bulletin 76:
Annual Accounting for Personal Needs Allowance Funds (PDF)
- Long Term Care Facility Bulletin 75:
Medex Premium Rate Increase (PDF)
- Long Term Care Facility Bulletin 74:
2001 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Skilled-Care Facilities (PDF)
- Long Term Care Facility Bulletin 73:
Update List of Department of Transitional Assistance Offices and Supplemental Security Income Regional Offices (PDF)
- Long Term Care Facility Bulletin 72:
Annual Accounting for Personal Needs Allowance Funds (PDF)
- Long Term Care Facility Bulletin 71:
Medex Premium Rate Increase (PDF)
- Long Term Care Facility Bulletin 70:
2000 Social Security Benefit Cost-of-Living-Adjustment (COLA) for Residents of Skilled-Care Facilities (PDF)
- Long Term Care Facility Bulletin 69:
Updates List of Department of Transitional Assistance and Supplemental Security Income Regional Offices (PDF)
- Long Term Care Facility Bulletin 68:
Requests for Payments of Funeral and Burial Expenses (PDF)
- Long Term Care Facility Bulletin 67:
MEDEX Premium Rates Increase (PDF)
- Long Term Care Facility Bulletin 66:
Annual Accounting for Personal Needs Allowance Funds (PDF)
Limited Services Clinic
- Limited Services Clinic Bulletin 2:
Additional Service Code for Limited Services Clinics (PDF)
- Limited Services Clinic Bulletin 1:
New MassHealth Limited Services Clinics Provider Type (PDF)
Managed Care Organization
- Managed Care Organization Bulletin 2:
Changes to the Notification of Birth (NOB-1) Form (PDF)
Municipally Based Health Services (See also School-Based Medicaid)
- Municipally Based Health Services Bulletin 16:
Change of Program Name of Municipal Medicaid to School-Based Medicaid; Continuation of Administrative Activity Claiming (AAC); and an Introduction to the Random-Moment Time Study (PDF)
- Municipally Based Health Services Bulletin 15:
Eliminating Administrative Activity Claiming (AAC) (PDF)
- Municipally Based Health Services Bulletin 14:
Parental Authorization to Share Information with MassHealth (PDF)
- Municipally Based Health Services Bulletin 13:
Changes in Department of Education Placement Categories (PDF)
- Municipally Based Health Services Bulletin 12:
Administrative Activities Claiming and General Payment Condition for Direct Services (PDF)
- Municipally Based Health Services Bulletin 11:
Administrative Claiming (PDF)
file size 4MB
- Municipally Based Health Services Bulletin 10:
Services Provided to Special Education Students (PDF)
file size 3MB
- Municipally Based Health Services Bulletin 9:
Services Provided to Special Education Students (PDF)
- Municipally Based Health Services Bulletin 8:
Program and Administrative Activity Claiming (PDF)
- Municipally Based Health Services Bulletin 7:
Increased Per Diam Rates (PDF)
Mental Health Center
- Mental Health Center Bulletin 28:
Services Provided by a Medicare-Noncertified Clinician (PDF)
- Mental Health Center Bulletin 27:
Crisis Intervention Services Provided to Dually Entitled Members (PDF)
- Mental Health Center Bulletin 26:
Prior Authorizations for Certain Brand-Name Products (PDF)
- Mental Health Center Bulletin 25:
Prior Authorization for Sedative-Hypnotic Sleep Medications (PDF)
Nurse Midwife
- Nurse Midwife Bulletin 12:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
- Nurse Midwife Bulletin 11:
HCFA Common Procedure Coding System (HCPCS) Update (PDF)
- Nurse Midwife Bulletin 10:
Injectable and Infusible Drugs and Devices (PDF)
- Nurse Midwife Bulletin 9:
Obtaining Prior Authorization and Submitting Claims for Synagis (Palivizumab) (PDF)
- Nurse Midwife Bulletin 8:
New Address for Prior Authorization Requests for Drugs (PDF)
- Nurse Midwife Bulletin 7:
Prior Authorization for Celebrex in Dosages of 200 mg or More (PDF)
- Nurse Midwife Bulletin 6:
Prior Authorization for Enbrel, Herceptin, and Remicade (PDF)
Nurse Practitioner
- Nurse Practitioner Bulletin 12:
Revisions to the MassHealth Dental Program (PDF)
- Nurse Practitioner Bulletin 11:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
- Nurse Practitioner Bulletin 10:
HCFA Common Procedure Coding System (HCPCS) Update (PDF)
- Nurse Practitioner Bulletin 9:
Injectable and Infusible Drugs and Devices (PDF)
- Nurse Practitioner Bulletin 8:
Obtaining Prior Authorization and Submitting Claims for Synagis (Palivizumab) (PDF)
- Nurse Practitioner Bulletin 7:
New Address for Prior Authorizations Requests for Drugs (PDF)
- Nurse Practitioner Bulletin 6:
Prior Authorization for Celebrex in Doseages of 200 mg or More (PDF)
- Nurse Practitioner Bulletin 5:
Prior Authorization for Enbret, Herceptin, and Remicade (PDF)
Nursing Facility
- Nursing Facility Bulletin 132:
Reestablishment of the Nursing Facility Pay for Performance (NF P4P) Program
- Nursing Facility Bulletin 131:
Administrative Annual Review Process for Certain MassHealth Members Residing in Nursing Facilities (PDF)
- Nursing Facility Bulletin 130:
Nursing Facility Resident Census Data Collection (PDF)
- Nursing Facility Bulletin 129:
MassHealth Nursing Facility Pay-for-Performance Program (PDF)
- Nursing Facility Bulletin 128:
Revision to Level I Preadmission Screening (PAS) Form-Correction (PDF)
- Nursing Facility Bulletin 127:
Revision to Level I Preadmission Screening (PAS) Form (PDF)
- Nursing Facility Bulletin 126:
Reinstatement of Payment For Medical Leave-of-Absence (MLOA) and Non-Medical-Leave-of-Absence (NMLOA) Days (PDF)
file size 4MB
- Nursing Facility Bulletin 125:
Revisions to the Nursing Facility Preadmission Process (PDF)
file size 4MB
- Nursing Facility Bulletin 124:
Electronic Claim Submissions for Members with Medicare and Commercial Insurance (PDF)
- Nursing Facility Bulletin 123:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
- Nursing Facility Bulletin 122:
Appeal Rights of Nursing Facility Residents Booklet (PDF)
- Nursing Facility Bulletin 121:
Revision of Forms: Level I PAS (Preadmission Screening), and Request for Services (PDF)
- Nursing Facility Bulletin 120:
Handling Schedule VI Medications in Nursing Facilities (PDF)
- Nursing Facility Bulletin 119:
Administrative Simplification Electronic Submission of Management Minutes Questionnaire (MMQ) Data (PDF)
- Nursing Facility Bulletin 118:
Revision to Nursing Facility Pre-Admission Screening and Annual Resident Review (PASARR) Process and Reporting Requirements (PDF)
- Nursing Facility Bulletin 117:
Changes in the Long Term Care Assessment Form (PDF)
- Nursing Facility Bulletin 116:
Revisions to the Notification of Clinical Eligibility for Nursing-Facility Services (PDF)
Oxygen
- Oxygen Bulletin 13:
Clarification of Coverage of Formulas (Enteral-Nutrition Products) (PDF)
- Oxygen Bulletin 12:
New Options for Required Accreditation (PDF)
Personal Care Attendant
- Personal Care Agency Bulletin 7:
Administrative Review Process for Certain MassHealth Members Including Community Elders and Disabled Adults and Children
- Personal Care Agency Bulletin 6:
MassHealth Community Services Critical Incident Report Form
- Personal Care Agency Bulletin 5:
Clarification of MassHealth Personal Care Regulations (PDF)
- Personal Care Agency Bulletin 4:
Changes to MassHealth Policy about the Provision of MassHealth Personal Care Attendant (PCA) Services to Hospice Members (PDF)
- Personal Care Agency Bulletin 3:
Temporary Emergency Personal Care Attendant (PCA) Services Plan (PDF)
Pharmacy
- Pharmacy Bulletin 73:
Pharmacy Facts (PDF)
- Pharmacy Bulletin 72:
Controlled Substances Management Program (PDF)
- Pharmacy Bulletin 71:
Changes to Pharmacy Co-payments (PDF)
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RTF
- Pharmacy Bulletin 70:
Usual and Customary Care (PDF)
- Pharmacy Bulletin 69:
On-line Submission of Pharmacy Claims (PDF)
- Pharmacy Bulletin 68:
Reference Chart re: Medications in Nursing Facilities (PDF)
- Pharmacy Bulletin 67:
Injectable and Infusible Drugs and Devices (PDF)
- Pharmacy Bulletin 66:
Suspension of Pharmacy Bulletin 64 - PA for Sedative-Hypnotic Sleep Medications (PDF)
- Pharmacy Bulletin 65:
Suspension of Pharmacy Bulletin 62 - Certain Brand-Name Multi-Source Drugs (PDF)
- Pharmacy Bulletin 64:
Prior Authorization for Sedative-Hypnotic Sleep Medications (PDF)
- Pharmacy Bulletin 63:
Billing Pharmacy Claims for MassHealth Members with Third-Party Insurance (PDF)
- Pharmacy Bulletin 62:
Prior Authorization for Certain Brand-Name Products (PDF)
- Pharmacy Bulletin 61:
Pharmacy Claims with Third-Party Insurers (PDF)
- Pharmacy Bulletin 60:
Obtaining Prior Authorization and Submitting Claims for Synagis (Palivizumab)
- Pharmacy Bulletin 59:
New Address for Prior Authorization Requests for Drugs
- Pharmacy Bulletin 58:
Prior Authorization for Celebrex in Dosages of 200 mg or More (PDF)
Physician
- Physician Bulletin 92:
Updated Vision Care Material Order Form
- Physician Bulletin 91:
Anesthesia Services and 5010 Requirements (PDF)
- Physician Bulletin 90:
Pediatric Immunization Administration Codes (PDF)
- Physician Bulletin 89:
Updated Drug Screen Testing Unit Limitation (PDF)
- Physician Bulletin 88:
Clarification of Coverage of Formulas (Enteral-Nutrition Products)
- Physician Bulletin 87:
Clarification of Coverage of Formulas (Enteral-Nutrition Products) (PDF)
- Physician Bulletin 86:
Medical Nutrition Therapy and Diabetes Self-Management Training (PDF)
- Physician Bulletin 85:
Correction for MassHealth Tobacco Cessation Counseling Benefit Chart (PDF)
- Physician Bulletin 84:
2006 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Physician Bulletin 83:
Guideline for Medical Necessity Determination for Breast Reduction (PDF)
file size 3MB
- Physician Bulletin 82:
2005 Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Physician Bulletin 81:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 4MB
- Physician Bulletin 80:
Delay in Implementation of New Prior Authorization Policy for Certain Therapy Services (PDF)
file size 3MB
- Physician Bulletin 79:
Administrative Simplification for Claims Requiring Attachments (PDF)
- Physician Bulletin 78:
Controlled Substances Management Program (PDF)
- Physician Bulletin 77:
Revisions to the MassHealth Dental Program (PDF)
- Physician Bulletin 76:
HIV Resistance Testing (PDF)
- Physician Bulletin 75:
Physician Supervision fo Anesthesia (PDF)
- Physician Bulletin 74:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
- Physician Bulletin 73:
HCFA Common Procedure Coding System (HCPCS ) Update (PDF)
- Physician Bulletin 72:
Injectable and Infusible Drugs and Devices (PDF)
- Physician Bulletin 71:
Reporting Anesthesia Time (PDF)
- Physician Bulletin 70:
Obtaining Prior Authorization and Submitting Claims for Synagis (Palivizumab) (PDF)
- Physician Bulletin 69:
Lyme Disease Vaccine (PDF)
- Physician Bulletin 68:
New Address for Prior Authorization Requests for Drugs (PDF)
- Physician Bulletin 67:
Prior Authorization for Celebrex in Dosages of 200 mg or More (PDF)
- Physician Bulletin 66:
Prior Authorization for Enbrel, Herceptin, and Remicade (PDF)
Podiatrist
- Podiatrist Bulletin 16:
Elimination of Life and Safety Requirement (PDF)
- Podiatrist Bulletin 15:
Healthcare Common Procedure Coding System (HCPCS) Coding Update (PDF)
- Podiatrist Bulletin 14:
Elimination of Global Billing for Services with a Professional and a Technical Component (PDF)
file size 3MB
- Podiatrist Bulletin 13:
Administrative Simplification for Claims Requiring Attachments (PDF)
- Podiatrist Bulletin 12:
Controlled Substances Management Program (PDF)
- Podiatrist Bulletin 11:
Elimination of PCC Referral Requirement for Clinical Laboratory Tests (PDF)
- Podiatrist Bulletin 10:
New Address for Prior Authorization Requests for Drugs (PDF)
- Podiatrist Bulletin 9:
Podiatry Services for Members Enrolled in MassHealth Managed Care Organizations (PDF)
Prescriber
- Prescriber Bulletin 5:
Suspension of Prescriber Bulletin 2 - PA for Sedative-Hypnotic Sleep Medications (PDF)
- Prescriber Bulletin 4:
Suspension of Prescriber Bulletin 1 - Certain Brand-Name Multi-Souce Drugs (PDF)
- Prescriber Bulletin 3:
Pneumococcal Conjugate Vaccine (PDF)
- Prescriber Bulletin 2:
Prior Authorization for Sedative-Hypnotic Sleep Medications (PDF)
- Prescriber Bulletin 1:
Prior Authorization for Certian Brand-Name Products (PDF)
Primary Care Clinician
- Primary Care Clinician 1:
PCC Registration and Multiple-Site Linking for the Provider Online Service Center (PDF)
Psychiatric Inpatient Hospital
- Psychiatric Inpatient Hospital Bulletin 22:
Revisions to the Nursing Facility Preadmission Process (PDF)
file size 4MB
- Psychiatric Inpatient Hospital Bulletin 21:
Electronic Claim Submissions for Members with Medicare and Commercial Insurance (PDF)
- Psychiatric Inpatient Hospital Bulletin 20:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format
- Psychiatric Inpatient Hospital Bulletin 19:
Changes in Clinical Assessment Forms (PDF)
- Psychiatric Inpatient Hospital Bulletin 18:
Psychiatric Inpatient Hospital Services for Eligible MassHealth Members Ages 2 through 64 - Not Enrolled in Managed Care (PDF)
Psychiatric Outpatient Hospital
- Psychiatric Outpatient Hospital Bulletin 3:
Return of Overpayments - Medicare Crossover Claims for Outpatient Hospital Services (PDF)
file size 4MB
- Psychiatric Outpatient Hospital Bulletin 2:
Clarification of Provider Manuals (PDF)
- Psychiatric Outpatient Hospital Bulletin 1:
Admission Hour Required on All Psychiatric Outpatient Hospital Claims (PDF)
Radiation Oncology Center
- Radiation Oncology Center 1:
New MassHealth Provider Type (PDF)
Rehabilitation Center
- Rehabilitation Center Bulletin 11:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 4MB
- Rehabilitation Center Bulletin 10:
Delay in Implementation of New Prior Authorization Policy for Certain Therapy Services (PDF)
file size 3MB
Renal Dialysis Clinic
- Renal Dialysis Clinic Bulletin 4:
Reporting National Drug Code (NDC) Information for Physician-Administered Drugs by Dialysis Clinics on Institutional Claims (PDF)
Rest Home
- Rest Home Bulletin 33:
New Status Change for Residents in a Rest Home (SC-1-RH) Form (PDF)
- Rest Home Bulletin 32:
Increase in Personal Needs Allowance (PDF)
- Rest Home Bulletin 31:
2007 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Rest Homes (PDF)
- Rest Home Bulletin 30:
2006 Social Security Benefit Cost-of-Living Adjustment (COLA) for Residents of Rest Homes (PDF)
- Rest Home Bulletin 29:
Implementation of the 837 Institutional HIPAA-Compliant Electronic Claim Format (PDF)
School-Based Medicaid (See also Municipally Based Health Services)
- School-Based Medicaid Bulletin 21:
Medicaid National Correct Coding Initiative (NCCI) for School-Based Medicaid Providers
- School-Based Medicaid Bulletin 20:
HIPAA 5010 Diagnosis Code Requirement for School-Based Medicaid Providers
- School-Based Medicaid Bulletin 19:
Updates on School-Based Medicaid Programs (PDF)
- School-Based Medicaid Bulletin 18:
The School-Based Medicaid Program (PDF)
- School-Based Medicaid Bulletin 17:
The School-Based Medicaid Program (PDF)
Speech and Hearing Center
- Speech and Hearing Center Bulletin 11:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 4MB
- Speech and Hearing Center Bulletin 10:
Delay in Implementation of New Prior Authorization Policy for Certain Therapy Services (PDF)
file size 3MB
Sterilization Clinic
- Sterilization Clinic Bulletin 7:
Elimination of Global Billing for Services with a Professional and a Technical Component (PDF)
file size 3MB
Substance Abuse Treatment
- Substance Abuse Treatment Bulletin 9:
Level III.5 or Clinical Support Services (PDF)
- Substance Abuse Treatment Bulletin 8:
Diagnosis Code Required for All Substance Abuse Claims (PDF)
- Substance Abuse Treatment Bulletin 7:
Move of Central Processing Unit to Charlestown (PDF)
- Substance Abuse Treatment Bulletin 6:
Prior Authorization for Certain Brand-Name Products (PDF)
- Substance Abuse Treatment Bulletin 5:
Prior Authorization for Sedative-Hypnotic Sleep Medications (PDF)
Therapist
- Therapist Bulletin 13:
New Prior Authorization Policy for Rehabilitation Therapy Services (PDF)
file size 4MB
- Therapist Bulletin 12:
Prior Authorizations Submitted by Therapist Group Practices (PDF)
file size 4MB
- Therapist Bulletin 11:
Delay in Implementation of New Prior Authorization Policy for Certain Therapy Services (PDF)
file size 3MB
Transportation
- Transportation Bulletin 15:
Specialty Care Transport (Service Code A0434) (PDF)
- Transportation Bulletin 14:
Administrative Simplification for Claims Requiring Attachments (PDF)
file size 3MB
Vision Care
- Vision Care Bulletin 16:
Updated Vision Care Material Order Form
- Vision Care Bulletin 15:
New Vision Care Materials Order Form (VIS-1) Form (PDF)
- Vision Care Bulletin 14:
Nursing Home/Home Visits for Vision Care Services and Pick-up and Delivery of Eyeglasses (PDF)
- Vision Care Bulletin 13:
MassHealth Essential to Cover Visual Analysis by Optometrists (PDF)
- Vision Care Bulletin 12:
New Address for Prior Authorization Requests for drugs (PDF)
Wig
- Wig Provider Bulletin 1:
Waiver Policy for Electronic Claim Submissions
This information is provided by MassHealth.