Guidelines for Medical Necessity Determination

The MassHealth Guidelines for Medical Necessity Determination (Guidelines) are used by MassHealth's reviewing clinicians to determine the medical necessity of prior-authorization requests submitted by providers.

Guidelines for Medical Necessity Determination: Email Notification

Sign up to receive email notification of updates to the MassHealth Guidelines.

Note: When you click on the sign up link, a blank e-mail should appear. If your settings prevent this, you may also copy and paste the following into your email address line.

[e-mail]

Just send the blank email as it's addressed. No text in the body or subject line is needed.