Message Text – December 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.

12/09/2025

Mailing Discontinued for PT-1 Provider Expiration Notices

Effective December 1, 2025, Provider Expiration Notices for Provider Requests for Transportation (PT-1s) will no longer be mailed. Please continue to monitor the Upcoming Expirations tab within the Customer Web Portal (CWP) for updates on existing PT-1 status.

If you have questions, please contact MassHealth at [e-mail] or [phone]. LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

Adjustments on Medicare Crossover Claims for Discarded Drugs

MassHealth implemented edit 9974 “PM: deny-service not covered/payable by MassHealth” in May 2025 to deny crossover claims billed with modifier JW ‘drug amount discarded/not administered to any patient’. Use of this modifier is not permitted under MassHealth policy, as outlined in Subchapter 6 of the Provider Manual.

In October 2025, MassHealth identified a system issue that caused crossover claims for Qualified Medicare Beneficiaries (QMB) to deny incorrectly. This issue was corrected on 10/20/25 and all affected crossover claims have been adjusted. These adjustments will appear on subsequent remittance advices.

Please note, edit 9974 applies only to crossover claims for members who are not QMB. Crossover claims for QMB members will continue to pay in accordance with federal regulations.

If you have questions, please contact MassHealth at [e-mail] or [phone]. LTSS providers, please contact the LTSS Provider Service Center at [phone] or [e-mail].

Upcoming Changes to EVS & POSC Hospice Information Display

Beginning 12/21/25, the Eligibility Verification System (EVS) and Provider Online Service Center (POSC) will show key details when a member elects the MassHealth Hospice Benefit, including the hospice provider’s information (DBA name, address, phone, PID/SL, NPI), and the member’s MassHealth and Medicare hospice enrollment dates (if available).

A reminder will also appear for providers to coordinate all non-hospice services with the hospice provider.

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:	December 8, 2025