Message Text – June 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.

06/24/2025

Provider online service center pre-login and post-login page refresh

Beginning June 29, 2025, MMIS will implement updates to the Provider Online Service Center (POSC) homepage, enhancing its visual design and overall functionality. These enhancements will affect both the pre-login and post-login interfaces and will include a revised message for unauthorized service access attempts.

The redesigned pre-login page will display banner alerts at the top, reposition the 'Login' button for greater visibility, and introduce a 'View Broadcast Messages' button. Additionally, it will provide a clearly listed set of available pre-login services.

The new post-login page will feature an updated Left Navigation menu, accessible immediately after login. A 'View Broadcast Messages' button will be introduced, and all services previously available on the pre-login page will remain accessible on the post-login screen.

The Unauthorized Access Page is displayed when a POSC user attempts to access a Left Navigation function without the necessary permissions. With the POSC refresh, this page will be enhanced to include an image for improved clarity and will offer troubleshooting guidance. The pre-login services will also remain accessible from this page.

The POSC URL (https://mmis-portal.ehs.state.ma.us/EHSProviderPortal) will not be changing as part of this refresh. Users can continue to use the system as usual and there is no change to their login credentials.

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].

06/17/2025

Reinstatement of Primary Care Referral Requirements for Orthotics and Prosthetics Services

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, including orthotics and prosthetics, for the Primary Care Accountable Care Organizations (ACO) and the Primary Care Clinician (PCC) Plan.

Effective for claims with dates of service on and after August 1, 2025, MassHealth will reinstate referral requirements for orthotics and prosthetics 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.

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

06/10/2025

Claims Reprocessed for Updated Community Health Center Procedure Codes

MassHealth has updated the Service Codes and Descriptions (Subchapter 6) for J0696, Q9991 and Q9992 of the Community Health Center Manual.

MassHealth updated its system for these coding changes effective for dates of service on or after January 1, 2025. All affected claims were reprocessed as of 5/19/25 and should appear on past or future remittance advices.

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

06/03/2025

Reminder: For MassHealth Members Who Have Elected the MassHealth Hospice Benefit and Need Services Unrelated to the Terminal Illness and Related Conditions

MassHealth providers must meet the necessary documentation requirements when the requested service or product is not related to the palliation or management of a member’s terminal illness, related conditions, or is not part of the member’s hospice plan of care. This is especially important for non-hospice providers submitting claims to MassHealth. Hospice providers must coordinate with and provide documentation to the non-hospice provider, offering clarification that the requested service or product is not related to the conditions outlined in 130 CMR 437.426: Payment of Hospice Services (I) Non-hospice Providers.

This information should minimally include the following information:

• Date of service,
• MassHealth Member ID,
• Reason for denial (e.g., not related to hospice, non-covered hospice service, etc.),
• Hospice letterhead, and
• Contact information including name of coordinating person at the hospice location.

Failure of the billing provider to submit the required documentation may result in the claim being denied. If a hospice provider determines that the requested treatment is related to the member’s terminal illness, the hospice provider must document this in the member’s plan of care and the hospice provider is responsible for payment as required by 130 CMR 437. At no time should the MassHealth member be billed per 130 CMR 450.403(A) and 130 CMR 450.403(B).

If you or your agency has questions regarding this communication, please contact the LTSS Provider Service Center at [phone] or [e-mail].

Update for Quarterly Drug Code Rates Effective April 1, 2025

MassHealth has completed the rate updates for the April 1, 2025 Quarterly Drug codes. The impacted claims will be reprocessed and/or adjusted and will appear on a future remittance advice.

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

101 CMR 339.00: Rates for Restorative Services Now Posted on Mass.gov

Provider Regulations 101 CMR 339.00: Rates for Restorative Services has been posted on Mass.gov and can be found in the Rates for Restorative Services. Effective June 6, 2025, MassHealth will be amending 101 CMR 339.00: Rates for Restorative Services.

Newly Added Caregiver Training Service Codes:

Effective June 6, 2025, therapy providers may begin using service codes 97550, 97551, and 97552. MassHealth will update Subchapter 6 for the Therapist Manual, Rehabilitation Center Manual, and Speech and Hearing Center Manual with the effective date of June 6, 2025. Rates for these services can be found at 101 CMR 339.00: Rates for Restorative Services.

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

Date published:	June 2, 2025
Last updated:	June 23, 2025