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Message Text – January 2019

MassHealth Provider Remittance Advice

The messages listed below may be general All Provider messages, applicable to several provider types or services, or provider specific. 

You can request a copy of a prior message by:

  • Emailing providersupport@mahealth.net
  • Sending a letter to

      MassHealth Customer Service
      P.O. Box 121205
      Boston, MA  02112-1205
     
  • Calling MassHealth Customer Services Center at (800) 841-2900,
    Hours: Monday – Friday 8 a.m. – 5 p.m.

01/22/19

New updated version of the DME/OXY payment & coverage guideline tool

Pharmacy providers with a Durable Medical Equipment and Supplies (DME) or Oxygen and Respiratory Therapy Equipment (OXY) specialty, DME and Oxygen providers are advised that the MassHealth DME and Oxygen Payment and Coverage Guideline Tool has been updated on 1/11/19 and posted on the MassHealth website. To confirm that you are using the most recent version of the applicable Tool, go to https://tinyurl.com/y97ys39u.

Please note that HCPCS Code A4223 has been added to the Tool for the dates of service on or after 1/8/19.

If you have any questions regarding this change, please contact the LTSS Provider Service Center at support@masshealthltss.com or call 1-844-368-5184.

 

Reminder for acute inpatient hospitals

Reminder:  If an Acute Inpatient claim encounters edit 6215 (HCAC claim eligible for cost outlier payment), please upload pertinent documentation without using a delay reason code. The claim “to” date must be within the one year billing deadline. Refer to Appendix V for instruction.  For claims over one year, refer to final deadline appeal procedures (All provider bulletin 232, Feb 2013).

If you have any questions, please contact the MassHealth Customer Service Center at 1-800-841-2900 or e-mail providersupport@mahealth.net.

01/15/19

101 CMR 334.00: prostheses, prosthetic devices and orthotic devices

Effective 12/28/18 MassHealth has published updated rates for 101 CMR 334.00: Prostheses, Prosthetic Devices and Orthotic Devices.

These new rates can be found at https://tinyurl.com/y7soz569.

The effective date of these updated rates is 12/28/18.

If you have any questions, please contact the LTSS Provider Service Center at support@masshealthltss.com or call 1-844-368-5184.

01/08/19

DMEPOS competitive bidding program: temporary gap period

MassHealth Competitive Bid Providers will be receiving a termination letter in accordance with the CMS Competitive Bid Gap Period described below. Provider files will be closed with an end date effective 12/31/2018. 

All Medicare Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) Competitive Bidding Program contracts expire on December 31, 2018. Starting January 1, 2019, there will be a temporary gap in the entire DMEPOS Competitive Bidding Program that CMS expects will last until December 31, 2020. For additional information, please see the Temporary Gap Period fact sheet on CMS’s website at https://tinyurl.com/y84q4n4s.

If you have any questions regarding this change, please contact the LTSS Provider Service Center at support@masshealthltss.com or call 1-844-368-5184.

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