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Reprocessing of Adult Day Health (ADH) Claims for Dates of Service 05/17/19 Through 06/30/19

September 16, 2019

MassHealth has identified that a number of ADH providers failed to update their billing systems to align with the ADH annualization rates effective for dates of service from May 1, 2019 through June 30, 2019. MMIS will be reprocessing claims for dates of service from May 17, 2019 through June 30, 2019. This Retroactive Reprocessing will correct for the rate increase indicated in the revised ADH rate regulations promulgated on May 17, 2019 with an effective date of May 1, 2019. MMIS has already reprocessed claims for the period of May 1, 2019 through May 16, 2019.

Moving forward, providers must ensure that their billing systems contain the current rates for ADH services. Any adjustments needed after this reprocessing will be the responsibility of the provider.

If you have questions, please contact the LTSS Provider Service Center at 1-844-368-5184 or