The Pharmacy Manual contains the regulations and administrative and billing instructions for pharmacies. The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. See 114.3 CMR 31.00.

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 Pharmacy 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

Preface

Subchapters 1 through 3: Administrative and Billing Regulations

Subchapter 4

Subchapter 5: Administrative and Billing Instructions

Important Note: Pharmacies participating in MassHealth should refer to the POPS Billing Guide pdf format of POPS Billing Guide
for billing instructions. For instructions for electronic billing, refer to the MassHealth Companion Guides.

The Administrative and Billing Instructions are divided into seven parts.

Appendix A

Appendix C

Appendix D

Appendix U

Appendix V

Appendix W

Appendix X

Appendix Y

Appendix Z


This information is provided by MassHealth.

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