Message Text – January 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.

01/27/2026

Application Updates as of January 2026

Providers are reminded to request applications and submit them to MassHealth within a 90-day timeframe to ensure that an outdated version is not submitted for enrollment.

As of January 2026, MassHealth has begun rolling out changes to its applications to include new information fields that will be displayed in the Mass.gov Provider Directory. Long-Term Services and Supports (LTSS) and dental providers are reminded to utilize their respective provider portals, and all other provider types should use MassHealth Provider Self-Service to request the most recent version of applications.

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].

01/20/2026

Attention Needed for Outdated Revalidation Contacts

If you belong to a group practice or facility that revalidates providers for MassHealth, please ensure that your organization’s revalidation contact information is current and accurate. MassHealth must be able to reach your designated contact and verify required information for your providers during the revalidation process. If revalidation contacts do not respond or complete necessary actions, providers may be disenrolled from MassHealth. To avoid disruptions, update your contact information promptly if it has changed.

All providers should notify MassHealth at least 14 days prior to any change in their information and may request updates to their provider file by visiting MassHealth Provider Self-Service.

For additional questions, or to submit a new contact, email the MassHealth Revalidation team at [e-mail].

Attention MassHealth Provider and Third-Party Vendors Acting on Their Behalf

MassHealth is requesting that providers confirm the provider’s status (enrolled or application pending) using the MassHealth Provider Self‑Service (PSS) to avoid completing and submitting duplicate applications. This is essential for third-party vendors that may not be aware of a provider’s status. The PSS can be accessed at: MassHealth Provider Self-Service. Please use the ‘Check Provider Enrollment Status’ and the ‘Check the Provider Application Status’ options.

If the provider is not enrolled or there is not an application in process, select the ‘Apply to Become a MassHealth Provider’ link to request an application.

For questions or concerns, please contact MassHealth at [phone] or [e-mail].

Commonwealth of Massachusetts Accounting System Upgrade

In anticipation of the Commonwealth of Massachusetts upgrading its accounting system in mid-January, Run100869 included expedited claims for some providers. Due to the postponement of the upgrade to mid-February, typical prudent pay rules will be back in place for Run 100870.

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].

01/13/2026

Provider Directory Self-Service Update - Coming January 2026

Effective January 30, 2026, Provider Directory update requests will be available through MassHealth Provider Self-Service. Providers are required to maintain accurate profiles and update their Directory information whenever changes occur. This update allows providers to modify details such as telehealth availability, languages spoken, accessibility accommodations, website URL, and whether they are accepting new patients.

CMS requires that Provider Directory data elements remain current and accurate. To review or request an update to your information, visit the Provider Self-Service site, select “Request Provider File Update”, and choose the Provider Directory option.

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

Claims Reprocessed for July 2025 Subchapter 6 Code Updates

MassHealth is updating the Service Codes and Descriptions (Subchapter 6) of the Physician and Acute Outpatient Hospital Manual to incorporate drug codes as well as HCPCS/Current Procedural Terminology (CPT), as applicable.

MassHealth updated its system to reflect the changes effective for dates of service on or after July 1, 2025. All affected claims will be reprocessed and will appear on this or future remittance advices.

If you have any questions, please contact the MassHealth Customer Service Center at [e-mail].

01/06/2026

UPDATE: Advancing Interoperability and Improving Prior Authorization Processes

Effective January 1, 2026, prior authorizations (PAs) for the medical benefit will be adjudicated as outlined below:

• Standard PA requests: A decision will be provided within seven calendar days from the date received, provided all necessary documentation is included.
• Expedited PA requests: A decision will be provided within 72 hours when the member’s clinical condition requires urgent attention and a delay in processing could negatively affect health outcomes. If the request does not meet the criteria for expedited review, it will be processed as a standard request and follow standard review processes.

Additional details about these process changes are available in the All Provider Bulletin 413 that was issued on November 20, 2025 at All Provider Bulletins, and the MassHealth’s Implementation of Interoperability and Prior Authorization Requirements web page.

For Provider Online Service Center (POSC) Users: Updates have been made to the POSC to reflect these changes. Namely, a new PA Classification field has been added to the POSC and allows providers to submit standard PAs or requests to expedite a PA. There is also an “Expedited” option available under the new PA Classification field within the POSC; however, providers should be aware that selecting “Expedited” will only result in an error upon submitting the PA. Again, within the POSC, providers may only submit standard PAs, or requests to expedite a PA; providers cannot submit a PA as “expedited”.

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].

Date published:	January 5, 2026
Last updated:	January 26, 2026