Guidance for All Providers

  • COVID-19 Health Care Provider Financial Relief Package will support health care providers impacted by and responding to the COVID-19 public health emergency. Through MassHealth, Baker-Polito Administration is distributing over $800 million in critical stabilization funding to the Commonwealth’s vital providers. PDF | Word
  • MassHealth All Provider Bulletin 298: MassHealth Telehealth Policy reinstates and extends MassHealth's current telehealth policy (as reflected in All Provider Bulletins 289, 291, and 294) until December 31, 2020, with some modifications. This extended policy will help ensure members retain access to covered services, promote social distancing, and mitigate the spread of COVID-19. Note: this bulletin does not apply to MassHealth programs overseen by the Office of Long Term Services and Supports, which will publish separate guidance on telehealth. PDF | Word
  • All Provider Bulletin 295: Hospital-Determined Presumptive Eligibility (HPE) Flexibilities during COVID-19 Emergency provides guidance on expanded HPE flexibilities for all individuals meeting the eligibility criteria for MassHealth Standard coverage. PDF | Word
  • All Provider Bulletin 292: Billing Policies for Coronavirus Disease 2019 (COVID-19) Testing and Treatment Services for Uninsured Individuals and MassHealth Limited Members provides guidance regarding how providers should bill for COVID-19 testing and treatment services for uninsured patients and MassHealth Limited members in light of the federal government's claims submission program for uninsured residents. PDF  | Word
  • All Provider Bulletin 290: Coverage Provided via Hospital-Determined Presumptive Eligibility expands eligibility for HPE to include individuals who have received HPE benefits in the past 12 months. PDF | Word
  • All Provider Bulletin 288: Coverage Provided via Hospital-Determined Presumptive Eligibility expands eligibility for HPE for individuals diagnosed with or presumptive COVID-19 to include individuals who have received HPE benefits in the past 12 months. PDF | Word

Guidance for Managed Care Entities

  • Managed Care Entity Bulletin 43: Requirements for Adult Day Health Services Delivered Remotely (via Telehealth and In-Home Settings) and Enhanced Rates for Adult Day Health Services During the Reopening Period (August 1, 2020, through November 30, 2020) outlines MassHealth’s expectations for integrated care plans regarding payment, coverage, and billing for the delivery of Adult Day Health (ADH) services remotely via telehealth or in an in-home setting and directs plans to institute temporary rate increases. PDF | Word
  • Managed Care Entity Bulletin 38: Limited Modification and Extension of Temporary Incremental Rate Increase for Inpatient Mental Health Services in Response to COVID-19 Pandemic directs managed care plans to modify and extend the temporary rate increases for facilities designated as Tier 2 by the Department of Mental Health (DMH) as set forth in this bulletin. PDF | Word
  • Managed Care Entity Bulletin 35: Temporary Rate Increases due to COVID-19 National Emergency directs One Care plans, Senior Care Organizations (SCOs), and PACE organizations to institute temporary rate increases​ for a number of providers including Residential Rehabilitative Services and Continuous Skilled Nursing Services. PDF | Word
  • MassHealth Managed Care Entity Bulletin 32: UPDATE: Temporary Rate Increases Due to COVID-19 National Emergency provides clarifications and updates to Managed Care Entity Bulletin 24 and provides guidance on additional residential rehabilitation services incremental rate increase for May and June 2020. ​PDF | Word
  • Managed Care Entity Bulletin 27: Temporary Retainer Payments Due to COVID-19 National Emergency directs One Care plans and Senior Care Organizations (SCOs) to institute temporary payments in the form of retainer payments for Adult Day Health providers to ensure these providers receive crucial stabilization funding for serving members enrolled in integrated care plans during the COVID-19 emergency. PDF | Word
  • Managed Care Entity Bulletin 23: Temporary Rate Increases Due to COVID-19 National Emergency directs One Care plans, Senior Care Organizations (SCOs), and Program of All-Inclusive Care for the Elderly (PACE) organizations to institute temporary rate increases and provides additional guidance regarding financial stabilization funding. PDF | Word
  • MassHealth Community Partner Information: Updates Related to the Coronavirus Disease 2019 (COVID-19) PDF | Word

Guidance for Health Safety Net

  • Administrative Bulletin: 20-09: 101 CMR 613.00: Health Safety Net Eligible Services; 101 CMR 614.00: Health Safety Net Payments and Funding: Health Safety Net Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID-19) establishes provider flexibilities and expanded coverage consistent with MassHealth’s fee for service program PDF | Word

Guidance for Pharmacies

  • Pharmacy Facts 141: Updates Related to Coronavirus Disease 2019 (COVID-19) Effective March 14, 2020 PDF | Word

Guidance for Clinical Laboratories

N/A

Guidance for Long Term Services and Supports (LTSS) Providers

  • Adult Day Health Bulletin 19: Additional Guidance and Requirements for Reopening Adult Day Health Programs During Phase III outlines additional guidelines and requirements for ADH programs including use of risk/benefit tools, reporting to MassHealth on program rosters, and reporting processes when a staff member or participant tests positive for COVID-19. PDF | Word
  • Adult Day Health Bulletin 18: Guidance for Adult Day Health (ADH) Providers Delivering Telehealth/Remote Services During the COVID-19 Public Health Emergency consolidates and restates, with relevance to ADH services, MassHealth’s current telehealth policy, as well as in-home setting services and extends that policy through December 31, 2020.  PDF | Word
  • Adult Day Health Bulletin 17: Enhanced Rates for Adult Day Health Services During the Reopening Period (August 1, 2020, through November 30, 2020) and Billing Instructions for Standard Rates sets forth enhanced rates that have been established to address reduced member utilization of day program services that is occurring as day programs ramp up and reopen following their required closure during the spring of 2020. PDF | Word
  • Chronic Disease and Rehabilitation Inpatient Hospital Bulletin 92: Temporary Suspension of the 45-Day Administrative Day Nonpayment Provision Under 130 CMR 435.000 extends the temporary suspension of its enforcement of the 45-day administrative day (AD) nonpayment provision to help address challenges around safely discharging MassHealth members to appropriate settings due to the COVID-19 pandemic. PDF | Word
  • Chronic Disease and Inpatient Rehabilitation Hospital Bulletin 91: Temporary Suspension of the 45-Day Administrative-Day Nonpayment Provision under 130 CMR 435.000 provides guidance on the suspension of the 45-day administrative nonpayment provision, which aims to support safe hospital discharges of MassHealth members to appropriate settings. PDF | Word
  • Day Habilitation Bulletin 12: Additional Guidance and Requirements for Reopening Day Habilitation Programs During Phase III outlines additional guidelines and requirements for DH programs including use of risk/benefit tools, reporting to MassHealth on program rosters, and reporting processes when a staff member or participant tests positive for COVID-19. PDF | Word
  • Day Habilitation Bulletin 11: Guidance for Day Habilitation (DH) Providers Delivering Telehealth/Remote Services During the COVID-19 Public Health Emergency consolidates and restates, with relevance to DH services, MassHealth’s current telehealth policy, as well as in-home setting services, and extends that policy through December 31, 2020. PDF | Word
  • Day Habilitation Bulletin 10: Enhanced Rates for Day Habilitation Services During the Reopening Period (August 1, 2020, through November 30, 3030) and Billing Instructions for Standard Rates - Corrected sets forth the enhanced rates and billing instructions for standard rates that have been established to address reduced member utilization of day program services that is occurring as day programs ramp up and reopen following their required closure during the spring of 2020. PDF | Word
  • HCBS Waiver Provider Bulletin 4:  Guidance for Home and Community-Based Services (HCBS) Waiver Providers Delivering Telehealth/Remote Services During the COVID-19 Public Health Emergency consolidates and restates MassHealth’s current telehealth policy for HCBS Waiver services, and extends that policy through February 28, 2021, consistent with Appendix K. PDF | Word
  • HCBS Waiver Provider Bulletin 3: Enhanced Rates for ABI and MFP Waiver Day Services, Community-Based Day Supports, Prevocational Services, and Supported Employment During the Reopening Period (August 1, 2020, through November 30, 2020) and Billing Instructions for Standard Rates for Day Services sets forth the enhanced rates and billing instructions for standard rates for day services, community-based day supports, prevocational services, and supported employment that have been established to address reduced member utilization of day program services that is occurring as waiver participants begin returning to day programs following closures and/or access limitations related to COVID-19 during the spring of 2020. PDF | Word
  • HCBS Waiver Provider Bulletin 2: FY19 Supplemental Budget Surplus Distribution outlines changes to the implementation of the Commonwealth of Massachusetts’ FY19 Supplemental Budget and distribution of funds to HCBS waiver providers. PDF | Word
  • Home Health Agency Bulletin 68: Extended MassHealth Telehealth Policy for Home Health Services and New Telehealth Documentation Requirement describes a COVID-19-related telehealth flexibility for MassHealth home health services that will remain in effect beyond September 13, 2021, until the end of the FPHE; clarifies that telehealth visits may be used for follow-up visits that do not require any hands-on care; and describes a new recordkeeping and documentation requirement regarding telehealth services. PDF | Word
  • Home Health Agency Bulletin 63: MassHealth Telehealth Policy for Home Health Services - Extension explains MassHealth’s policy for the use of telehealth for certain home health services and extends the policy until 90 days after the final date of the Governor’s Declaration of a State of Emergency. PDF | Word
  • Home Health Agency Bulletin 60: MassHealth Telehealth Policy for Home Health Services explains MassHealth’s policy for the use of telehealth for certain home health services through March 31, 2021. PDF | Word
  • Home Health Agency Bulletin 59: FY19 Supplemental Budget Surplus Distribution outlines changes to the implementation of the Commonwealth of Massachusetts’ FY19 Supplemental Budget and distribution of funds to home health agencies. PDF | Word
  • Home Health Agency Bulletin 58: Implementation of Rate Add-On Applicable to Certain Continuous Skilled Nursing Serves to Address Costs Associated with Coronavirus Disease 2019 (COVID-19) ​provides guidance on program requirements associated with the rate add-on as established in Administrative Bulletin 20-63. PDF | Word
  • Nursing Facility Bulletin 163: Reporting on Staff Hours and Staffing Preparedness for Nursing Facilities requires nursing facilities to report on their staffing levels each month, effective April 1, 2021. The requirements align with, and supplement, the quarterly reporting on staffing levels required by 42 CFR 483.70(q) and will be used to determine facilities’ standard rate adjustments under 101 CMR 206.13(2). PDF | Word
  • Nursing Facility Bulletin 157: Updated COVID-19 Ongoing Surveillance Testing Requirements for Nursing Facilities supersedes previous Nursing Facility bulletins regarding surveillance testing to provide updates in alignment with the most recent Department of Public Health guidance. PDF | Word
  • Nursing Facility Bulletin 156: Updated Coronavirus Disease 2019 (COVID-19) Isolated Spaces for Nursing Facilities ​supersedes previous bulletins to establish criteria for nursing facilities to designate wings, units, or floors, separated from the rest of the facility and referred to here as “isolation spaces,” to provide nursing facility services to COVID-19 positive residents. PDF | Word
  • Nursing Facility Bulletin 153: Deadline Extension for Reporting Room Density in Nursing Facilities extends the submission deadline for attestation and reporting requirements outlined in Nursing Facility Bulletin 151 to 11:59 p.m. on October 30, 2020. PDF | Word
  • Nursing Facility Bulletin 152: COVID-19 Ongoing Surveillance Testing Requirements for Nursing Facilities​ ​outlines updated requirements for surveillance testing in nursing homes, superseding Nursing Facility Bulletin 148 to align with updated guidance​ from the Dep​artment of Public Health. PDF | Word
  • Nursing Facility Bulletin 151: Room Density Reporting and Planning for Nursing Facilities describes new requirements for nursing facilities to report the number of rooms by type (single, two-bedded, three-bedded, and four-bedded) within their facility and attest to taking immediate steps towards reducing or eliminating three and four bedrooms. PDF | Word
  • Nursing Facility Bulletin 150: Coronavirus Disease 2019 (COVID-19) Isolated Spaces for Nursing Facilities establishes criteria for nursing facilities to designate wings, units, or floors, separated from the rest of the facility, to provide nursing facility services to COVID-19 positive residents. PDF | Word
  • Nursing Facility Bulletin 148: COVID-19 Baseline and Surveillance Testing Requirements for Nursing Facilities ​establishes the requirements that nursing facilities must meet for a second round of baseline testing and on-going surveillance testing of Staff, and testing of symptomatic or COVID-19 exposed residents or exposed Staff, as outlined by the guidance issued on June 30, 2020 by the Department of Public Health (DPH). PDF | Word
  • Nursing Facility Bulletin 147: Signing Bonuses for Nursing Facility Staff ​provides guidance for nursing facilities regarding MassHealth funding for qualifying signing bonuses that eligible nursing facilities pay to incentivize hiring of direct care staff through the Commonwealth's Long Term Care Portal. PDF | Word
  • MassHealth Nursing Facility Provider Bulletin 146: COVID-19 Baseline Testing Requirements for Nursing Facilities ​​outlines the baseline COVID-19 testing requirements nursing facilities must meet to receive supplemental payments and includes the attestation nursing facilities must submit to demonstrate that they have met these requirements. ​PDF | Word
  • Nursing Facility Bulletin 145: Infection Control Competencies and Expectations for Nursing Facilities. This provider bulletin establishes the expectations for COVID-19 infection control competencies at nursing facilities in the Commonwealth.  It also establishes an audit process for evaluating nursing facilities' implementation of the infection control competencies and requires each nursing facility to complete an initial self-assessment and attestation of such competencies. PDF | WORD
    • Self-assessment checklist Excel
    • MassHealth Nursing Facility COVID-19 Accountability and Support Frequently Asked Questions (FAQ) PDF | Word
  • MassHealth LTSS Provider Information: Updates Related to the Coronavirus Disease 2019 (COVID-19) PDF Word
  • Guidance for community day programs
  • Guidance for long term care facilities
    • Isolated Spaces for Nursing Facility Residents with a positive Coronavirus Disease 2019 (COVID-19) Diagnosis: This bulletin establishes criteria for nursing facilities to designate wings, units, or floors that are separated from the rest of the facility to provide services to COVID-19 positive residents. PDF | Word
    • MassHealth Nursing Facility Investment to Support Dedicated COVID-19 Isolation Spaces PDFWord
    • MassHealth Investment to Support Signing Bonuses for Nursing Facility Staff​ PDF | Word
    • Information About Signing Bonuses Available for Long Term Care Facility Staff
      English PDF | Word Spanish PDF | Word
  • Resident Care Facility Bulletin 34: COVID-19 Signing Bonuses for Resident Care Facility Staff ​provides guidance regarding signing bonuses that eligible resident care facilities pay to incentivize new direct care staff to work in resident care facilities during the public health emergency. PDF | Word

Guidance for Behavioral Health Providers

  • Acute Inpatient Hospital Bulletin 177: Limited Modification and Extension of Financial Support for Certain Acute Inpatient Hospitals with DMH-Licensed Beds in Response to the COVID-19 Pandemic provides guidance on modifications to and extensions of some of the financial support described in Acute Inpatient Hospital Bulletin 175. PDF | Word
  • Acute Inpatient Hospital Bulletin 175: Financial Support for Acute Inpatient Hospitals with DMH-Licensed Beds in Response to the COVID-19 Pandemic outlines the financial support MassHealth is providing to acute inpatient hospitals with Department of Mental Health (DMH)-licensed beds (Applicable Hospitals) meeting specific eligibility criteria and provides guidance on the eligibility requirements for this funding. PDF | Word
  • Psychiatric Inpatient Hospital Bulletin 26: Limited Modification and Extension of Financial Support for Certain DMH-Licensed Psychiatric Hospitals in Response to the COVID-19 Pandemic provides guidance on modifications to and extensions of some of the financial supports described in Psychiatric Inpatient Hospital Bulletin 25. PDF | Word
  • Psychiatric Bulletin 25: Financial Support for DMH-Licensed Psychiatric Hospitals in Response to the COVID-19 Pandemic outlines the financial support MassHealth is providing to Department of Mental Health (DMH)-licensed inpatient psychiatric hospitals meeting specific eligibility criteria and provides guidance on eligibility requirements for this funding. PDF | Word
  • MassHealth Mental Health Center Bulletin 34 UPDATE: Mental Health Center Transformation Incentive Payments makes changes to Mental Health Center Bulletin 32 including an addition to payment eligibility requirements and revisions to performance requirements. PDF | Word
  • Mental Health Center Bulletin 32: Mental Health Center Transformation Incentive Payments provides guidance for mental health centers regarding COVID-19 stabilization funding that is intended to support eligible providers as they transition from delivering in-person services to using other care delivery modalities in response to the public health emergency PDF | Word

Guidance for Community Health Centers, Physicians and Group Practices

  • UPDATED (New Due Date for Applications) – MassHealth Physician Bulletin 101: Alternative Interim Payments ​provides guidance on eligibility criteria providers must meet to request an alternative interim payment pursuant to this bulletin and Administrative Bulletin 20-62. UPDATED PDF | UPDATED Word

Guidance for Dental Providers

  • UPDATED (New Due Date for Applications) MassHealth Dental Bulletin 47: Alternative Interim Payments provides guidance on eligibility criteria dental providers must meet to request an alternative interim payment pursuant to this bulletin and Administrative Bulletin 20-61. UPDATED PDF | UPDATED Word

Guidance for Transportation Brokers, Transportation Providers, and Drivers

  • Transmittal Letter TRN-36: Transportation Manual (COVID-19 Updates to Subchapter 6)​ PDF | Word

Guidance for Early Intervention Providers

  • Early Intervention Bulletin 3: Temporary Extension of Coverage for Early Intervention Services​ outlines the MassHealth policy to pay for the provision of Early Intervention services to eligible children who turn three years old between March 15, and August 31, 2020, to provide a “bridge” between EI and appropriate Early Childhood Special Education (ECSE) services​. PDF | Word

Guidance on MassHealth Eligibility & Applications during COVID-19

  • Eligibility Operations Memo 20-10: Hospital-Determined Presumptive Eligibility (HPE) Flexibilities during COVID-19 Emergency PDF | Word
  • Eligibility Operations Memo 20-07: Updates to Hospital-Determined Presumptive Eligibility (HPE) Application Process PDF | Word
  • Eligibility Operations Memo 20-06: Updates to the Hospital-Determined Presumptive Eligibility (HPE) Application Process PDF | WORD

Guidance for Mass Immunizer Providers

N/A

Guidance for Telehealth Network Providers

  • Provider Participation Requirements, Covered Encounters and Other Information​ PDF​ | Word
Last updated: October 29, 2021
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