Providers can find regulations, bulletins, manuals, forms, and other information they might need as MassHealth-participating providers.
Are you interested in applying to become a MassHealth provider? Find out here.
Are you interested in becoming a PCC? Learn about eligibility requirements and more.
You can learn how to access and check a member’s eligibility using our Eligibility Verification System (EVS) via the Provider Online Service Center (POSC).
Are you a MassHealth provider and do you need to submit a claim? You can follow this guide to submit claims online via the Provider Online Service Center (POSC).
Learn how to check the status of your MassHealth claim on the Provider Online Service Center (POSC).
Are you a MassHealth provider who needs non-emergency transportation for a MassHealth member? You can request it here.
Do you need to request a prior authorization (PA) for a prescription drug? Search for the right forms here.
MassHealth must receive your initial claim within 90 days of the service date. If you cannot meet this requirement, you can ask for a 90-day waiver for certain conditions that are described in the 90-day waiver request form.
Are you unable to submit claims online? Learn how you can apply for an electronic claims waiver.
Are you a MassHealth nonpharmacy provider? Do you need a prior authorization (PA)? You can find and submit forms here. Send PA requests via the Provider Online Service Center (POSC).
If you are a MassHealth-contracted Personal Care Management (PCM) agency and you need to request a prior authorization (PA) for PCA services, use the forms below.
You must submit all claims electronically unless you have an approved electronic claims waiver to submit paper claims.
The Provider Online Service Center (POSC) allows enrolled providers to view member eligibility, update provider information, submit and check claims, obtain and manage service authorizations, and conduct other self-service activities.
If the application fee presents a significant financial hardship, you can submit a hardship exception request.
Do you need to pay a fee to enroll, reenroll, or revalidate as a MassHealth provider? You can do it here.
Trainings available for MassHealth providers
The Executive Office of Health and Human Services and its contracted private psychiatric hospitals require all behavioral health providers to report all adverse incidents involving a MassHealth member.