MassHealth identified certain Mental Health Center crossover claims with dates of service on or after September 1, 2025, were reimbursed incorrectly. In addition, some crossover claims denied in error for edit 4257 “Provider contract modifier restriction on procedure”. Corrections were implemented in MMIS, and affected Medicare crossover claims were adjusted and will appear on this and subsequent remittance advices.
If you have questions or concerns, please contact MassHealth at (800) 841-2900 or provider@masshealthquestions.com.
Mental Health Center Crossover Claim Adjustments