MassHealth Payment and Coverage Guideline Tools

See below for the MassHealth DME and Oxygen Payment and Coverage Guidelines Tool and the MassHealth Orthotics and Prosthetics Payment and Coverage Guidelines Tools.

MassHealth DME and Oxygen Payment and Coverage Guidelines Tool

If you want to receive e-mail alerts when MassHealth posts changes to the DME and Oxygen Payment and Coverage Guidelines Tool, Sign up here. 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 join-masshealth_dme_oxy_guidlines@listserv.state.ma.us into your e-mail address line. Just send the blank e-mail as it's addressed. No text in the body or subject line is needed. 

This online tool provides abbreviated descriptions for all durable medical equipment and oxygen service codes covered by MassHealth, identifies applicable modifiers, place-of-service codes, prior-authorization requirements, service limits, and pricing and markup information.

Additional Resources

MassHealth Orthotics and Prosthetics Payment and Coverage Guidelines Tool

If you want to receive e-mail alerts when MassHealth posts changes to the Orthotics and Prosthetics Payment and Coverage Guidelines Tools, Sign up here. 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 join-masshealth_ort_prt_paymnt_coverage_guidelines_tool@listserv.state.ma.us into your e-mail address line. Just send the blank e-mail as it's addressed. No text in the body or subject line is needed.

This online tool provides abbreviated descriptions for all orthotics and prosthetics service codes covered by MassHealth, identifies applicable modifiers, place-of-service codes, prior-authorization requirements, service limits, and pricing and markup information.

Additional Resources

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