Message Text – August 2025

MassHealth Provider Remittance Advice

The messages listed below may be general All Provider messages, applicable to several provider types or services, or provider specific. 

You can request a copy of a prior message by:

• Emailing [e-mail]
• Sending a letter to

  MassHealth Customer Service
  P.O. Box 278
  Quincy, MA 02171

• Calling MassHealth Customer Services at [phone],
  Hours: Monday through Friday 8 a.m. to 5 p.m.

08/26/2025

Hearing Aid Claim Denials & Prior Authorization

This is a reminder that Prior Authorization (PA) is required if a member has received a hearing aid within the last five (5) years. Please remember that a PA is approved for the provider that requests the PA using the requesting provider’s MassHealth provider ID or National Provider Identifier (NPI). When submitting hearing aid claims, please ensure that the PA’s requesting provider ID or NPI matches the rendering/servicing provider ID or NPI on the PA. If the provider ID or NPI on the PA does not match the rendering/servicing provider ID or NPI on the claim, the claim will deny.

If you have questions, please contact MassHealth at [phone] or [e-mail].

08/19/2025

Provider File Updates: Fax Submissions to be Discontinued Effective September 2025

Effective September 2025, provider file update requests for non-LTSS and non-dental MassHealth providers will no longer be accepted via fax. To ensure timely processing of your updates moving forward, please visit the Provider Self-Service site, available at MassHealth Provider Self-Service. Only updates submitted to Provider Enrollment and Credentialing (PEC) through self-service and by mail will be accepted.

Providers may access the training ‘PEC Self-Service Resources’ in the provider learning management system for non-LTSS and non-dental providers. This training will give instructions on how to submit a request for provider file updates along with other provider requests.

If you have questions, please contact MassHealth at [phone] or [e-mail].

08/12/2025

Announcing CANS changes kick off Meeting

The Executive Office of Health and Human Services (EOHHS) has procured a vendor to update the online application for the Child/Adolescent Needs and Strengths (CANS) Assessment. Starting in early calendar year 2026, the CANS assessment will be moved to the eCAS platform. To start this migration, all providers who see youth under the age of 21 for behavioral health services and complete the CANS assessment are invited to a general kick off on 8/19/2025 at noon. Attendees should be those with knowledge of current systems and oversight of the use of the CANS. This meeting will also discuss Electronic Health Record (EHR) integration and should be attended by those who are connected to the current HL7 process for uploading CANS to the Virtual Gateway or those interested in that process.

The meeting will be held by Zoom. Please register here to join.

08/05/2025

Reinstatement of Primary Care Referral Requirements

On March 20, 2020, as part of MassHealth’s COVID-19 response, the Executive Office of Health and Human Services suspended referral requirements for MassHealth covered services for the Primary Care Accountable Care Organizations (ACO) and the Primary Care Clinician (PCC) Plan.

Effective August 1, 2025, MassHealth is reinstating referral requirements for services provided to members in the PCC plan or a Primary Care ACO, as outlined in 130 CMR 450.118(J): Referral for Services and 130 CMR 450.119(I): Referral for Services.

For more information, please review All Provider Bulletin 403: Ending the Suspension of Primary Care Clinician Plan & Primary Care ACO Referrals and Updating Referral Requirements for Urgent Care Services: All Provider Bulletins 404-through-300.

Claims submitted to MassHealth for services that require a referral must include an authorized referring provider’s national provider identifier (NPI). The referring provider must also be enrolled with MassHealth for the claim to be payable. Billing providers must include the NPI of an authorized referring provider who is enrolled with MassHealth. This NPI must appear on every claim with a service that requires a referral for the claim to be payable.

For questions or concerns:

LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

All other providers, please contact MassHealth at [phone] or [e-mail].

Date published:	August 4, 2025
Last updated:	August 25, 2025