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Pharmacy Manual for MassHealth Providers

The Pharmacy Manual guides pharmacy providers to the regulations and the administrative and billing instructions 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 pharmacy providers, those matters are covered in 130 CMR 406.000, reproduced as Subchapter 4 in the Pharmacy Manual. 

The Executive Office of Health and Human Services (EOHHS) establishes rates for MassHealth services. These rate regulations for pharmacy services may be found in 101 CMR 331.00

Table of Contents

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

Subchapter 4: Pharmacy Providers Regulations

Subchapter 5: Administrative and Billing Instructions for all MassHealth Providers

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

Appendices for Pharmacy Providers (includes appendix D)



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