Massachusetts Administrative Code

Commonwealth of Massachusetts Division of Medical Assistance Provider Manual Series SUBCHAPTER NUMBER AND TITLE TABLE OF CONTENTS PAGE iv SPEECH AND HEARING CENTER MANUAL TRANSMITTAL LETTER SHC-16 DATE 07/01/05 4. PROGRAM REQUIREMENTS 413.401: Introduction .......................…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PUBLIC HEARING Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Mo…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Acute Inpatient Hospital Manual Transmittal Letter AIH-52 Date 01/02/15 4. Program Regulations 415.401: Introduction .............................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Hearing Instrument Specialist Manual Transmittal Letter HIS-24 Date 03/15/09 4. Program Regulations 416.401: Introduction ........................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Psychiatric Day Treatment Program Manual Transmittal Letter PDT-21 Date 01/25/19 4. Program Regulations 417.401: Introduction.....................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Substance Use Disorder Treatment Manual Transmittal Letter SUD-24 Date 03/28/2025 4. Program Regulations 130 CMR 418.000: Substance Use Disorder Treatment Service…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PUBLIC HEARING Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Fr…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Dental Manual Transmittal Letter DEN-111 Date 10/15/21 4. Program Regulations: Dental Services 420.401: Introduction .............................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Family Planning Agency Manual Transmittal Letter FPA-51 Date 01/02/15 4. Program Regulations 421.401: Introduction ...............................................…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PUBLIC HEARING Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Mo…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Freestanding Ambulatory Surgery Center Manual Transmittal Letter FAS-28 Date 01/02/15 4. Program Regulations 423.401: Introduction ...............................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Podiatrist Manual Transmittal Letter POD-74 Date 08/12/16 4. Program Regulations 424.401: Introduction ...........................................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Psychiatric Inpatient Hospital Manual Transmittal Letter PIH-23 Date 06/16/17 4. PROGRAM REGULATIONS 425.401: Introduction .......................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Audiologist Manual Transmittal Letter AUD-17 Date 01/02/15 4. Program Regulations 426.401: Introduction ..........................................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents (130 CMR 427.000) Page iv Oxygen and Respiratory Therapy Equipment Manual Transmittal Letter OXY-35 Date 04/28/23 4. Program Regulations 130 CMR 427.000: Oxygen and Respi…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PROPOSED AMENDMENT OF REGULATIONS Under the authority of M.G.L. c. 118E and in accordance with M.G.L. c. 30A, the Executive Office of Health and Human Services (EOHHS) will hold a public com…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Mental Health Center Manual Transmittal Letter MHC-53 Date 9/1/2025 4. PROGRAM REGULATIONS 429.401: Introduction .................................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title 4. Program Regulations (130 CMR 430.000) Page 4-1 Rehabilitation Center Manual Transmittal Letter RHB-21 Date 06/01/11 430.601: Introduction All rehabilitation centers participating in Mas…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Independent Diagnostic Testing Facility Manual Transmittal Letter IDTF-1 Date 07/01/06 4. Program Regulations 431.401: Introduction ..............................…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PROPOSED AMENDMENT OF REGULATIONS Under the authority of M.G.L. c. 118E, ss. 7 and 12 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) proposes to amen…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Physician Manual Transmittal Letter PHY-167 Date 07/07/23 4. Program Regulations 130 CMR 433.000: Physician Services Part 1. General Information 433.401: Definiti…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Psychiatric Outpatient Hospital Manual Transmittal Letter POH-4 Date 12/26/08 4. PROGRAM REGULATIONS 434.401: Introduction........................................…

Commonwealth of Massachusetts Division of Medical Assistance Provider Manual Series SUBCHAPTER NUMBER AND TITLE TABLE OF CONTENTS PAGE iv CHRONIC DISEASE AND REHABILITA- TION INPATIENT HOSPITAL MANUAL TRANSMITTAL LETTER CDR-22 DATE 02/01/00 4. PROGRAM REGULATIONS 435.401: Introdu…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Radiation Oncology Center Manual Transmittal Letter ROC-1 Date 06/01/11 4. Program Regulations 436.401: Introduction .............................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Hospice Manual Transmittal Letter HOS-18 Date 01/01/23 4. Program Regulations 130 CMR 437.000: Hospice Services 437.401: Introduction ............................…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PUBLIC HEARING Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Mo…

Commonwealth of Massachusetts Division of Medical Assistance Provider Manual Series SUBCHAPTER NUMBER AND TITLE TABLE OF CONTENTS PAGE iv EARLY INTERVENTION PROGRAM MANUAL TRANSMITTAL LETTER EIP-13 DATE 10/03/97 4. PROGRAM REGULATIONS 440.401: Introduction .....................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Chiropractor Manual Transmittal Letter CRP-24 Date 03/22/19 4. Program Regulations 441.401: Introduction .........................................................…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PROPOSED AMENDMENT OF REGULATIONS Under the authority of M.G.L. c. 118E and in accordance with M.G.L. c. 30A, the Executive Office of Health and Human Services (EOHHS) will hold a public com…

4. Program Regulations: 130 CMR 447.000: Acupuncture Services 447.401: Introduction .............................................................................................. 4-1 447.402: Definitions ............................................................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Community Behavioral Health Center Manual Transmittal Letter CBHC-1 Date 01/01/2023 4. Program Regulations: Community Behavioral Health Center Services 448.401: I…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PUBLIC HEARING Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the “Division”) will hold a remote public hearing on …

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Urgent Care Clinic Manual Transmittal Letter UCC-1 Date 01/21/22 4. Program Regulations: 130 CMR 455.000: Urgent Care Clinic Services 455.401: Introduction ......…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of contents Page iv Nursing Facility Manual Transmittal Letter NF-64 Date 09/08/25 4. Program Regulations 130 CMR 456.000: Long Term Care Services 456.401: Nursing Facility Services:…

4. Program Regulations: 130 CMR 457.000: Freestanding Birth Center Services 457.401: Introduction ............................................................................................................. 4-1 457.402: Definitions ...............................................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Homeless Medical Respite Services Manual Transmittal Letter HMR-1 Date 01/03/25 1. Program Regulations 130 CMR 458.000: Homeless Medical Respite Services 458.401:…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Community Support Program Services Manual Transmittal Letter CSP-1 Date 04/28/23 4. Program Regulations 130 CMR 461.000: Community Support Program Services 461.40…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents (130 CMR 462.000) Page iv Licensed Independent Behavioral Health Clinician Manual Transmittal Letter LICSW-2 Date 04/01/25 4. Program Regulations 130 CMR 462.000: License…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title 4. Program Regulations (130 CMR 463.000) Page iv Doula Services Manual Transmittal Letter DS-2 Date 11/08/24 4. Program Regulations: 130 CMR 463.000: Doula Services 463.401: Introduction .…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Program of Assertive Community Treatment Manual Transmittal Letter PACT-1 Date 11/1/2025 4. Program Regulations 130 CMR 464.000: Program of Assertive Community Tr…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title Table of Contents Page iv Abortion Clinic Services Manual Transmittal Letter ABR-19 Date 06/10/22 4. PROGRAM REGULATIONS 484.001: Definition of Payable Abortions ..........................…

Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title 4. Program Regulations (130 CMR 485.000) Page iv Sterilization Clinic Manual Transmittal Letter STR-18 Date 01/02/15 4. Program Regulations 485.401: Introduction ..........................…

1 130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 251 Rev. 02/13/2026 130 CMR 501.000: HEALTH CARE REFORM: MASSHEALTH: GENERAL POLICIES TABLE OF CONTENTS Section 501.001: Definition of Terms 501.002: Introduction to MassHealth 501.003: MassHealth Coverage Types 501.004: Ad…

1 130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 252 Rev. 02/13/2026 130 CMR 502.000: HEALTH CARE REFORM: MASSHEALTH: THE ELIGIBILITY PROCESS TABLE OF CONTENTS Section 502.001: Application for Benefits 502.002: Reactivating the Application 502.003: Verification of Eligibi…

1 130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 253 Rev. 02/13/2026 130 CMR 503.000: HEALTH CARE REFORM: MASSHEALTH: UNIVERSAL ELIGIBILITY REQUIREMENTS TABLE OF CONTENTS Section 503.001: Universal Eligibility Requirements 503.002: Residence Requirements 503.003: Social S…

130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 213 Rev. 01/01/14 MASSHEALTH: CITIZENSHIP AND IMMIGRATION Chapter 504 Page 504.000 TABLE OF CONTENTS Section 504.001: Introduction 504.002: U.S. Citizens 504.003: Immigrants 504.004: Verification of U.S. Citizenship and Ident…

1 130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 254 Rev. February 13, 2026 130 CMR 505.000: HEALTH CARE REFORM: MASSHEALTH: COVERAGE TYPES TABLE OF CONTENTS Section 505.001: Introduction 505.002: MassHealth Standard (130 CMR 505.003 Reserved) 505.004: MassHealth CommonHe…

1 130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 250 Rev. 01/30/2026 130 CMR 506.000: MASSHEALTH: FINANCIAL REQUIREMENTS TABLE OF CONTENTS Section 506.001: Introduction 506.002: Household Composition 506.003: Countable Household Income 506.004: Noncountable Household Inco…

Division of Medical Assistance Commonwealth of Massachusetts Office of Medicaid NOTICE OF PUBLIC HEARING Under the authority of M.G.L. c. 6A, section 16 and in accordance with M.G.L. c. 30A, the Division of Medical Assistance (the Division) will hold a remote public hearing on Fr…

1 130 CMR: DIVISION OF MEDICAL ASSISTANCE Trans. by E.L. 255 Rev. 02/13/26 130 CMR 515.000: MASSHEALTH: GENERAL POLICIES TABLE OF CONTENTS Section 515.001: Definition of Terms 515.002: Introduction to MassHealth 515.003: MassHealth Coverage Types 515.004: Administration of MassHe…