To allow for system maintenance, the MMIS POSC, Provider Portal, HTS transactions, internal MMIS application, EVS and all eligibility services… Continue Reading MMIS System Outage Notice – Sunday, February 15, 2026

The Commonwealth of Massachusetts is upgrading its accounting system in mid-February. This upgrade is expected to impact claim payments for… Continue Reading Commonwealth of Massachusetts Accounting System Upgrade

The Centers for Medicare and Medicaid Services (CMS) approved MassHealth’s deactivation request for the National Correct Coding Initiative (NCCI) Medicaid… Continue Reading Updates to NCCI Medicaid Durable Medical Equipment (DME) Medically Unlikely Edits (MUES) and NCCI Medicaid DME Procedure-to-Procedure (PTP) Edits

MassHealth has completed the rate updates for January 1, 2026, Quarterly Drug codes. The impacted claims will be reprocessed and/or… Continue Reading Update For Quarterly Drug Code Rates Effective January 1, 2026

As of January 2026, MassHealth has begun rolling out changes to its applications to include new information fields that will… Continue Reading Application Updates as of January 2026

Effective January 30, 2026, Provider Directory update requests will be available through MassHealth Provider Self-Service. Providers are required to maintain… Continue Reading Provider Directory Self-Service Update – Coming January 2026

Effective January 1, 2026, prior authorizations (PAs) for the medical benefit will be adjudicated as outline below: Standard PA requests:… Continue Reading Update: Advancing Interoperability and Improving Prior Authorization Processes

Starting January 1, 2026, independent nurses (INs) who are seeking a prior authorization (PA) to work with a Community Case… Continue Reading Plan of Care Submission Requirements