MassHealth CSN Provider Types

Learn about the two different MassHealth provider types that may provide you with nursing hours: CSN Agencies and Independent Nurses.

Regardless of which provider type is used, Community Case Management (CCM) families and members ultimately make the decision on how to use their authorized CSN hours.  If families need any assistance with locating providers or finding alternative LTSS services, CCM can help.  Please contact your Clinical Case Manager to discuss what options might be available.  Please see the CCM Onboarding Guide, which discusses the various options your CCM Clinical Manager may offer and provide you to help fill your CSN hours.

Continuous Skilled Nursing (CSN) Agencies

CSN agencies are public or private organizations that contract with MassHealth to provide CSN services only. CSN agencies do not need to enroll in Medicare and do not provide other home health services such as intermittent skilled nursing and home health aide services. CSN agency providers are required to follow MassHealth regulations at 130 CMR 403.000: Home Health Agency and 130 CMR 450.000: All Provider Manual, in addition to other relevant state and federal laws and regulations.

CSN agency providers employ licensed practical nurses and registered nurses, and these nurses provide CSN services to CCM Members. Agency nurses receive clinical supervision and oversight through the CSN agency.

If a CSN agency does not have the nursing available to meet the needs of a particular CCM member, the agency may work with the member and their family to help recruit nurses for the CCM member. 

130 CMR 438.000: CSN Agency: 130 CMR 438.000

Independent Nurses

Independent Nurses (IN) are Registered Nurses (RN) and Licensed Practical Nurses (LPN) who are enrolled as MassHealth independent providers. IN providers may only provide CSN services. 

For a program summary, please see the Independent Nurse Program Fact Sheet for Members and Families Document here. PDF | Word 

IN providers are not employed by MassHealth or otherwise employed by the Commonwealth of Massachusetts. IN providers are self-employed individuals who may be reimbursed by MassHealth for authorized CSN services delivered to MassHealth members. IN providers do not receive clinical supervision or clinical training from MassHealth or CCM.

IN providers must comply with MassHealth regulations at 130 CMR 414.000: Independent Nurse Services and 130 CMR 450.000: All Provider Manual, in addition to other relevant state and federal laws and regulations, for example, Board of Registration in Nursing licensure requirements.

To learn more about enrolling as an Independent Nurse, contact the LTSS Service Center by calling 844-368-5184 or emailing [e-mail].

Please see the Independent Nurse Getting Started Checklist here for an overview of steps an Independent Nurse needs to take to enroll with MassHealth PDF | Word

Nurses ready to enroll as an IN may visit the MassHealth LTSS Provider Portal to start an application. After selecting the Independent Nurse Provider Resource Link, scroll to 4: Enrollment, Revalidation, and Provider Updates, to begin an Independent Nurse provider application. 

130 CMR 414.000: Independent Nurse: 130 CMR 414.000