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Adjustments of Certain Adult Day Health Claims That Require a Prior Authorization That Were Paid in Error

August 21, 2023

MassHealth has identified a payment error with Adult Day Health claims that require a prior authorization (PA). This error caused certain claims to be overpaid. The affected claims with dates of service from April 1, 2023 to July 28, 2023, have been adjusted and will appear on this or a subsequent remittance advice. Any applicable claims that do not have a PA, have an invalid PA number, or have insufficient PA units will deny and applicable monies will be recouped.

If you have questions, please contact the LTSS Provider Service Center at (844) 368-5184 or