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Provider publications
Providers can find regulations, bulletins, manuals, forms, and other information they might need as MassHealth-participating providers.
Apply to become a MassHealth provider
Are you interested in applying to become a MassHealth provider? Find out here.
Apply to become a Primary Care Clinician (PCC) in the Primary Care Clinician Plan
Are you interested in becoming a PCC? Learn about eligibility requirements and more.
Check member eligibility
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).
Submit claims
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).
Check claim status
Learn how to check the status of your MassHealth claim on the Provider Online Service Center (POSC).
Request transportation for a member
Are you a MassHealth provider who needs non-emergency transportation for a MassHealth member? You can request it here.
Request a prior authorization for a drug
Do you need to request a prior authorization (PA) for a prescription drug? Search for the right forms here.
Submit a 90-day Claim Waiver Request Form
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.
Submit an electronic claims waiver request
Are you unable to submit claims online? Learn how you can apply for an electronic claims waiver.
Request prior authorization for nonpharmacy services
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).
Request prior authorization for PCA services
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.
MassHealth Billing Guides for Paper Claim Submitters
You must submit all claims electronically unless you have an approved electronic claims waiver to submit paper claims.
Register as a MassHealth provider on POSC
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.
Pay the provider application fee
Do you need to pay a fee to enroll, reenroll, or revalidate as a MassHealth provider? You can do it here.
MassHealth Provider Training
Trainings available for MassHealth providers
Behavioral Health - Reporting Adverse Incidents
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.