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MassHealth Provider Billing Tips

In addition to the instructions outlined in your billing manual, MassHealth has compiled several informational leaflets that summarize procedures and policies.

They were created in response to providers' most commonly asked questions. We have used these billing tip sheets as part of our training programs for some time and they have received positive feedback. They may be downloaded and printed and are useful as a training tool for your staff.

Documents

Acute Hospitals - Billing Instructions for Carve-out Drugs PDF | Word

Acute Inpatient Hospitals – Billing Instructions for Long-Acting Injectable (LAI) Antipsychotics Effective 5/15/2024 PDF | Word

Billing Instructions for LARC Devices Implanted Inpatient, Immediate Postpartum, Effective March 1, 2018 PDF | Word

Billing Instructions for Acute Inpatient Hospitals PDF | Word

Billing Tips for Methadone Code Changes PDF | Word

Nursing Facility Rate Add-Ons Billing Guidance Effective 10/1/2023 PDF | Word

Request for All Nursing Facility Rate Add-Ons DFF | Word

Contact Information for MassHealth Claim Questions PDF | Word

Correcting Errors 3120 and 3121 PDF | Word

Electronic Claim Submission PDF | Word

Home Health Billing Tips for Services Provided to Members Enrolled in a MassHealth MCO PDF | Word

Hospice Billing Tips PDF | Word

Hospice Billing Tips for Room and Board Charges When a Member is in a Long-Term Care Facility PDF | Word

All Provider Bulletin 256: The Overpayment Disclosure Process PDF | Word

Suspense Edits for Nursing Facility Claims - Claim Conflict Suspense Edits PDF | Word

Suspense Edits for Nursing Facility Claims - Level of Care Suspense Edits PDF | Word

Suspense Edits for Nursing Facility Claims - Member Eligibility Suspense Edits PDF | Word

Tracking Claims Pended for Fiscal Reasons PDF | Word

Understanding Accounts Receivable PDF | Word

Using Remittance Advance(s) to Reconcile Your Accounts PDF | Word

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