07/22/2025
Change in phone prompts for customer service
Effective 9/1/2025, the MassHealth Customer Service phone prompts will be changing. Providers will be required to enter their MassHealth Provider ID (PID) to connect with a Customer Service Agent.
If you are unsure of your MassHealth Provider ID (PID), please visit the Provider Self Service website and perform a Provider Enrollment Status check using your NPI. If you are a MassHealth enrolled provider, this will display your Provider ID and Service Location (PID/SL). Please note that for the current prompts we are only requiring the numerical portion to be entered, the 9-digit PID, and not the letter that corresponds to the service location.
You can access the Provider Enrollment Status check on Mass.gov.
Reminder of Ordering, Referring, Prescribing (ORP) Provider Requirements
As described in All Provider Bulletin 286 (with updated information provided in All Provider Bulletins 361, 376, 380, and 391), claims submitted to MassHealth for services that require an order, referral or prescription must include the national provider identifier (NPI) of an authorized ordering, referring or prescribing (ORP) provider. The ORP provider must also be enrolled with MassHealth for the claim to be payable.
Enter the ORP provider’s NPI in the Referring Provider field/segment if the claim 1) is for a service that requires a Primary Care Clinician (PCC) or Primary Care Accountable Care Organization (PCACO) referral; or 2) is for a laboratory service or a diagnostic testing service; or 3) is submitted on an 837I or UB-04 (such claims only have a Referring Provider field). Please note that an ORP provider’s NPI is only required on an 837I or UB-04 when the ORP provider is different than the Attending Provider. Enter the ORP provider’s NPI in the Ordering Provider field for all other impacted claims.
All Provider Bulletin 286 (and all of the referenced Bulletins) can be found on Mass.gov at: All Provider bulletins.
If you have questions, please contact MassHealth at (800) 841-2900 or provider@masshealthquestions.com.
07/01/2025
Early Intervention Telehealth Modifiers 93, FQ, and FR
MassHealth has updated codes T1015, T1023, T1024, T1027 to allow telehealth modifiers 93, FQ, and FR. Claims submitted by Early Intervention providers that were denied due to the use of these modifiers will be reprocessed and/or adjusted and will appear on a future remittance advice.
If you have questions, please contact MassHealth at (800) 841-2900 or provider@masshealthquestions.com.
Date published: | June 2, 2025 |
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Last updated: | July 21, 2025 |