In April 2024, providers were notified that the standard process of submitting 90-day waiver requests using delay reason codes 1, 4 and 8 was causing denials for Medicare Crossover requests instead of suspending the claims for review as intended. As a temporary solution, providers were instructed to use delay reason code 10 while the MMIS issue was being addressed. The MMIS system change has now been implemented effective 4/20/2025, therefore, providers should immediately return to the standard submission process using delay reason codes 1, 4, and 8 for 90-day waiver requests for all crossover claims.
For all 90-day waiver requests including crossover claims, providers are instructed to use the delay reason codes 1, 4 and 8 per the original requirements noted on All Provider Bulletin 220.
If you have any questions regarding this message, please contact MassHealth at (800) 841-2900 or provider@masshealthquestions.com. LTSS providers should contact the LTSS Provider Service Center at (844) 368-5184 or support@masshealthltss.com.