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MassHealth Payment and Coverage Guideline Tools

On this web page are the MassHealth DME & OXY Payment and Coverage Guideline Tool and the ORT & PRT Payment and Coverage Guideline Tool.

MassHealth Durable Medical Equipment and Oxygen Payment and Coverage Guideline Tool

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

If you want to receive e-mail alerts when MassHealth posts changes to the DME and OXY 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.

Additional Resources for MassHealth Durable Medical Equipment and Oxygen Payment and Coverage Guideline Tool

MassHealth Orthotics and Prosthetics Payment and Coverage Guideline Tool

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

If you want to receive e-mail alerts when MassHealth posts changes to the ORT and PRT 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.

Additional Resources for MassHealth Orthotics and Prosthetics Payment and Coverage Guideline Tool

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