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The ACA ORP Requirements for MassHealth Providers

This page contains information on how to enroll to be a MassHealth Ordering, Referring, and Prescribing (ORP) provider and how to access webinars.

Section 6401(b) of the Affordable Care Act (ACA) includes requirements related to Ordering, Referring, and Prescribing (ORP) providers. If MassHealth requires a service to be ordered, referred, or prescribed, then ACA Section 6401(b) requires that the

  • Billing provider include the ORP provider's individual National Provider Identifier (NPI) on the claim, and 
  • ORP provider be enrolled with MassHealth as a fully participating provider or as a nonbilling provider. 

For additional background information on the ACA 6401(b) rule, please see the What you need to know section below.

To view and download the nonbilling ORP Contract and Application, please see the Additional Resources section below.

Please complete, sign, and return this form and the Nonbilling Provider Contract by mail to:

MassHealth Customer Service Center (CSC)
Attn. Provider Enrollment
P.O. Box 278
Quincy, MA 02171-0005.

You can address questions about the form- to CSC. Dentists should submit the form and signed contract by mail to:

DentaQuest at Masshealth Dental Program
Attn: Provider Enrollment and Credentialing
P.O. Box 2906
Milwaukee, WI 53201-2906

What you need to know

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