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MassHealth Guidelines for Medical Necessity Determination H – V

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Table of Contents

Hair Removal

MassHealth Guidelines for Medical Necessity Determination for Hair Removal 

Home Health Services

MassHealth Guidelines for Medical Necessity Determination for Home Health Services 

Hospital Beds

MassHealth Guidelines for Medical Necessity Determination for Hospital Beds 

Knee Arthroplasty

MassHealth Guidelines for Medical Necessity Determination for Knee Arthroplasty 

Knee Arthroscopy

MassHealth Guidelines for Medical Necessity Determination for Knee Arthroscopy 

Mastectomy for Gynecomastia

MassHealth Guidelines for Medical Necessity Determination for Mastectomy for Gynecomastia 

Maternal Cell-Free DNA Testing

MassHealth Guidelines for Medical Necessity Determination for Maternal Cell-Free DNA Testing 

Occupational Therapy

Guide MassHealth Guidelines for Medical Necessity Determination for Occupational Therapy 

Organ Transplant Procedures

MassHealth Guidelines for Medical Necessity Determination for Organ Transplant Procedures 

Orthognathic Surgery

MassHealth Guidelines for Medical Necessity Determination for Orthognathic Surgery 

Physical Therapy

MassHealth Guidelines for Medical Necessity Determination for Physical Therapy 

Reduction Mammoplasty

MassHealth Guidelines for Medical Necessity Determination for Reduction Mammoplasty 

Speech and Language Therapy

MassHealth Guidelines for Medical Necessity Determination for Speech and Language Therapy 

Standers

MassHealth Guidelines for Medical Necessity Determination for Standers  

Support Surfaces

Guide MassHealth Guidelines for Medical Necessity Determination for Support Surfaces 

Varicose Veins of the Lower Extremities

MassHealth Guidelines for Medical Necessity Determination for Treatment of Varicose Veins of the Lower Extremities 
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