Message Text – September 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

• CallingMassHealth Customer Services at [phone],
  Hours: Monday through Friday 8 a.m. to 5 p.m.

09/29/2026

Update for Early Intervention Rate 96164 U2

MassHealth has completed the claim adjustments and reprocessing for Early Intervention service code 96164 U2. The impacted claims have been reprocessed and/or adjusted and will appear on a future remittance advice.

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

09/22/2026

Updates to MassHealth Provider Directory - Independent Nurse Contact Information

MassHealth is currently updating the online MassHealth Provider Directory - the MassHealth Provider Directory includes all MassHealth enrolled providers. This is a different directory than the Community Case Management (CCM) Nurse Directory, which is specifically for Continuous Skilled Nursing (CSN) providers and CCM members and families. As part of these updates, independent nurse profiles will now include each individual provider’s email address. This email address will be pulled from the provider’s application or LTSS profile.

If your current provider email address or any other contact information on file with MassHealth is not up to date, please log into the MassHealth LTSS Provider Portal and submit an update. MassHealth must have up to date contact information for all enrolled providers to ensure we can communicate with you in a timely manner. Independent nurses are required under MassHealth regulations to notify the MassHealth agency in writing within 14 days of any change in any of the information submitted in the provider application in accordance with 130 CMR 450.223(B) and 130 CMR 414.404(G).

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

The Centers for Medicare & Medicaid Services (CMS) Revised HCPCS Codes for April and July 2026

The Centers for Medicare & Medicaid Services (CMS) have revised the HCPCS codes for April and July 2026. Please reference Administrative Bulletin 26-17 for more information.

MassHealth made no changes as part of those April and July HCPCS code updates.

Please refer to the MassHealth Durable Medical Equipment and Oxygen & Respiratory Payment and Coverage Guideline Tool for a full description of the service codes, prior authorization requirements, service limits, modifiers, and allowable place-of-service codes.

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

Reprocessing Durable Medical Equipment (DME) Claims Denied in Error for Edit 2804

MassHealth identified that certain Durable Medical Equipment (DME) claims for Intermittent Urinary Catheter procedure codes A4295, A4296, and A4297 incorrectly denied for edit 2804 “Procedure is Invalid for Patient Sex”.

Corrections were implemented in MMIS, and the impacted claims with dates of service on or after January 1, 2026, have been reprocessed and will appear on this or a subsequent remittance advice.

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

09/01/2026

Clarification on PA submission requirements

Prior authorization (PA) is not required for the services listed in Subchapter 6 of the MassHealth Renal Dialysis Clinic Manual, including CPT code 90999. Please do not submit an unnecessary PA for these services as it will delay claims processing. However, per the Subchapter 6 guidance, providers may request a PA for a MassHealth Standard or CommonHealth member under 21 years of age if the service is medically necessary, reimbursable under the Federal Medicaid Act, and not listed as covered in Subchapter 6.

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

Important information for participating providers

Providers may now access the MassHealth Provider Handbook as a newly available resource on Mass.gov, and as a compliment to provider regulations.

The MassHealth Provider Handbook is intended to offer a comprehensive overview of resources that are available to providers. We hope that by accessing the Handbook, providers will be better able to navigate their experience while working with MassHealth and our members.

Date published:	September 1, 2026
Last updated:	September 28, 2026