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COVID Rate Increase for Code A4927 for DME/OXY Providers

November 9, 2020

Please be advised that the MassHealth Office of Long-Term Services and Supports (OLTSS) has increased the rate for code A4927 for non-sterile gloves to $11.00 per box of 100 for DME providers and Oxygen and Respiratory Equipment providers enrolled with a specialty in DME, effective for dates of service beginning July 1, 2020, pursuant to adoption of the emergency regulation 101 CMR 446.00: COVID-19 Payment Rates for Certain Community Health Care Providers. Refer to

MassHealth will adjust all claims with a "billed amount" of $11 or less, with dates of service from July 1, 2020 to October 30, 2020 for A4927, where there is a difference between the "billed amount" line of the claim and what was paid.

Providers who believe they qualify for the higher rate will need to submit a claim adjustment.

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