Message Text – February 2026

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.

02/10/2026

Commonwealth of Massachusetts Accounting System Upgrade

The Commonwealth of Massachusetts is upgrading its accounting system in mid-February. This upgrade is expected to impact claim payment for two cycles but will not impact the provider’s ability to submit transactions through MMIS.

There is no need to adjust claim submission during this time, but please plan for the adjusted payment schedule described below.

• Payments for Run 100873 (week of February 16th) may be issued one to two days earlier than usual and may include some expedited claims.
• Payments for Run 100874 (week of February 23rd) may be issued one to two days later than usual.

Between February 12 and February 23, VendorWeb will be impacted by the system upgrade. VendorWeb is expected to be available, but no new information will be posted during this time.

For questions or concerns, use the contact information below:

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].

02/03/2026

Update for Quarterly Drug Code Rates Effective January 1, 2026, 2026

MassHealth has completed the rate updates for January 1, 2026 Quarterly Drug codes. The impacted claims will be reprocessed and/or adjusted and will appear on a future remittance advice.

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

Updates to NCCI Medicaid Durable Medical Equipment (DME) Medically Unlikely Edits (MUEs) and NCCI Medicaid DME Procedure-to-Procedure (PTP) Edits

The Centers for Medicare and Medicaid Services (CMS) approved MassHealth’s deactivation request for the National Correct Coding Initiative (NCCI) Medicaid Durable Medical Equipment (DME) Medically Unlikely Edits (MUEs) for HCPCS codes A4224, A4338, A4349, A4351, A4352, A4353, A4357, A4358, A4606, A5120, A7031, A7032, A7033, A7038, and A7507.

CMS also approved MassHealth’s deactivation request for the NCCI Medicaid DME Procedure-to-Procedure (PTP) edits* for HCPCS codes:

(T4521-T4533), (T4522-T4534), (T4523-T4521), (T4524-T4522), (T4525-T4523), (T4526-T4525), (T4527-T4526), (T4528-T4527), (T4530-T4529), (T4532-T4531), (T4533-T4530), (T4534-T4532), (T4544-T4528)

* NCCI Medicaid DME Procedure-to-Procedure (PTP) edits refer to a specific pair of codes identified by the NCCI that shouldn't typically be billed together for the same patient on the same day. This is because one code is a component of the other or because the codes are mutually exclusive, with the Column 1 code usually paid and the Column 2 denied unless a specific modifier is identified.

Please refer to the most recent version of the MassHealth DME and OXY Payment and Coverage Guideline Tool for further instructions regarding service descriptions, coverage, limits, prior authorization, place-of-service codes, and applicable modifier requirements.

If you have questions regarding this message, please contact the LTSS Provider Service Center at [e-mail] or call (844)-368-5184.

Date published:	February 2, 2026
Last updated:	February 9, 2026