MassHealth Provider ID/Service Location
Each provider's national provider identifier is stored in MassHealth’s Medicaid Management Information System with a corresponding MassHealth provider identification/service location (PID/SL). A PID/SL has 10 characters: a nine-digit base number and an alpha service location letter (e.g., 123456789A). The provider’s PID/SL will be displayed on MassHealth reports as well as correspondence and remittance advices. Providers should maintain proof of their PID/SL, which will be part of the welcome letters they receive upon enrollment.
All MassHealth providers are required to maintain adequate documentation and records, such as their MassHealth PID/SL, in accordance with 130 CMR 450.205. You’ll also need your PID/SL to access the Provider Online Service Center, and you’re required to provide it if MassHealth requests it.
Provider File Maintenance
All MassHealth providers must notify MassHealth of any changes to information that was listed in their provider applications. Examples of changes include corporate/practice structure, changes in licensure, closure or opening of locations, and change of address.
MassHealth providers must notify MassHealth in writing within 14 days of any change in any information submitted in their provider applications. Failure to do so is a breach of their contract. See 130 CMR 450.222 and 130 CMR 450.223(B).
Some of the ways that providers can report their changes to MassHealth:
- Long-term services and supports (LTSS) providers must notify MassHealth of provider file changes through the LTSS provider portal.
- Dental providers must email providerrelations@massdhp.com about any changes to their provider files. Additional documentation or paperwork may be required.
Providers who are currently enrolled in MassHealth as fee-for-service (FFS) or ordering, referring, and prescribing (ORP) providers may submit a request to update their provider files using MassHealth Provider Self-Service at our Existing MassHealth Providers web page.
Fee-for-service provider file information is available in a public-facing provider directory.
MassHealth Provider Directory
MassHealth has an online Network Provider Directory that lists demographic information about medical and behavioral health (BH) providers, primary care providers, and specialists who are in the MassHealth FFS network. BH providers who are contracted with the Massachusetts Behavioral Health Partnership are also in this directory. The information in the directory is based on MassHealth provider file information. Therefore, providers need to make sure they keep their information up to date. Providers who are currently enrolled in MassHealth as FFS or ORP providers may submit a request to update their provider files using MassHealth Provider Self-Service at the Existing MassHealth Providers web page.
MassHealth Provider Revalidation
MassHealth providers are required to revalidate their information at least every five years.
As part of the required revalidation process, MassHealth must revalidate the enrollment information of all enrolled providers and site locations. Other information may also need to be collected using additional forms, such as a Federally Required Disclosure Form (FDRF).
MassHealth will select providers each month for revalidation based on their date of enrollment and will notify them 30 days before the start of their revalidation process.
Providers have 45 days after this notification to complete the revalidation process. Providers who fail to complete revalidation will be subject to termination and removal from the MassHealth program in accordance with federal and state guidelines. Terminated providers will also receive a letter from MassHealth at their primary doing-business-as (DBA) address. Learn more about revalidation at the Existing MassHealth Providers web page.
Policy Updates
MassHealth, like other insurance plans, may have changes in policies, procedure codes, and other requirements. Providers must stay aware of these changes by reviewing MassHealth bulletins, transmittal letters, and banner messages. Sign up to get an email whenever a new MassHealth provider bulletin or transmittal letter is published.
| Date published: | July 29, 2022 |
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| Last updated: | August 21, 2026 |