This page, Personal Care Manual for MassHealth Providers , is offered by

Personal Care Manual for MassHealth Providers

The Personal Care Manual guides personal care providers to the regulations, administrative and billing instructions, and service codes they need.

Administrative regulations and billing regulations apply to all providers and are contained in 130 CMR 450.000. These regulations are reproduced as Subchapters 1, 2, and 3 in this and all other manuals.

Program regulations cover matters that apply specifically to the type of provider for which the manual was prepared. For personal care providers, those matters are covered in 130 CMR 422.000, reproduced as Subchapter 4 in the Personal Care Manual. 

The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. These rate regulations for personal care services may be found in 101 CMR 309.00

Personal care management agencies and fiscal intermediaries are contracted providers with MassHealth. Applicants may apply to be PCM providers through COMMBUYS Resource Center. Fiscal intermediary contracts are closed.

Table of Contents

Subchapters 1 through 3: Administrative and Billing Regulations for all MassHealth Providers

Subchapter 4: Personal Care Providers Regulations

Subchapter 5: Administrative and Billing Instructions for all MassHealth Providers

Subchapter 6: Personal Care Service Codes

Appendices for All MassHealth Providers (includes appendices A, C, T, U, V, W, X, Y, and Z)

Contact

Phone

Open Monday–Friday 8 a.m.–5 p.m.

Open Monday–Friday 8 a.m.–5 p.m.

Fax

(617) 988-8974
Feedback