Each part of the Physician 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.
- Table of contents page v (PDF)
- Table of contents page vi (PDF)
Subchapters 1 through 3: Administrative and Billing Regulations
Subchapter 4: Physician Regulations
- Physician Regulations (PDF 1.03MB) file size 9MB
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)
- PHY Service Codes (PDF) file size 3MB
- Enrollment Centers (PDF) file size 1MB
This information is provided by MassHealth.