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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.

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