The Physician Manual contains the regulations, administrative and billing instructions, and service codes for physicians, nurse midwives, independent nurse practitioners, portable X-ray providers, and diagnostic imaging centers. 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 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

Preface

Subchapters 1 through 3: Administrative and Billing Regulations

Subchapter 4: Physician Regulations

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.

Subchapter 6

Appendix A

Appendix B

Appendix C

Appendix E

Appendix I

Appendix K

Appendix U

Appendix V

Appendix W

Appendix X

Appendix Y

Appendix Z


This information is provided by MassHealth.