The Adult Day Health Manual contains the regulations, administrative and billing instructions, and service codes for adult day health programs. The establishes rates for MassHealth services.
MassHealth issues transmittal letters to update any part of the provider manual. MassHealth issues provider bulletins to communicate information that is not contained in the provider manual.
Each part of the Adult Day Health Manual is listed below from beginning to end. You can print each part separately (or any individual pages) or print all parts for a complete manual.
MassHealth issues transmittal letters to update any part of the provider manual. MassHealth issues provider bulletins to communicate information that is not contained in the provider manual.
Each part of the Adult Day Health Manual is listed below from beginning to end. You can print each part separately (or any individual pages) or print all parts for a complete manual.
Table of Contents
Table of contents pages i, ii, ii-a, and iii appear at the beginning of Subchapter 1 below.
Table of contents page iv appears at the beginning of Subchapter 4 below.
Preface
Subchapters 1 through 3: Administrative and Billing Regulations
Subchapter 4
Subchapter 5: Administrative and Billing Instructions
For instructions for electronic billing, refer to the MassHealth Companion Guides. For instructions for billing MassHealth using paper claim forms refer to MassHealth Billing Guides for Paper Claim Submitters.
The Administrative and Billing Instructions are divided into seven parts.
- Part 1. Eligibility (PDF)
- Part 2. Prior Authorization (PDF)
- Part 3. Billing MassHealth (PDF)
- Part 4. Required Forms and Documentation (PDF)
- Part 5. Claim Status and Payment (PDF)
- Part 6. Claim Status and Correction (PDF)
- Part 7. Other Insurance (PDF)
Subchapter 6
Appendix A
Appendix B
- Enrollment Centers (PDF)
file size 1MB
Appendix C
Appendix D
Appendix U
Appendix V
Appendix W
Appendix X
Appendix Y
Appendix Z
This information is provided by MassHealth.
