Payment policies

All the policies below are in PDF format.

• Acupuncture payment policy
• Acute inpatient rehabilitation payment policy
• Adult day health payment policy
• Adult foster care payment policy
• Aging service access points (ASAP) payment policy
• Ambulatory surgery — facility payment policy
• Ambulatory surgery — professional payment policy
• Anesthesia payment policy
• Assistant surgeon payment policy
• Autism services payment policy
• Cardiology services payment policy
• Certified nurse midwife policy
• Claims editing software policy
• Clinical trials payment policy
• Code review payment policy
• Coding analysis policy
• Counseling/risk factor reduction intervention services payment policy
• Day habilitation
• Dental services - Fallon Medicare Plus and NaviCare, effective July 1, 2025
• Dental services - MassHealth ACO
• Dermatology payment policy
• Diabetes self-management education/training payment policy
• Drugs and biologicals payment policy
• Durable medical equipment payment policy
• Early intervention services payment policy
• Emergency department payment policy
• Evaluation and management payment policy
• Gastroenterology payment policy
• Global surgical payment policy
• Group adult foster care payment policy
• Health-related social needs (HRSN) supplemental services - MassHealth ACO
• Hearing aid and hearing aid exam payment policy
• Home delivered meals payment policy
• Home health care payment policy
• Hospice payment policy
• Hospice services – MassHealth ACO and NaviCare SCO (Medicaid-only)
• Hospital acquired conditions payment policy
• Infertility/assisted reproductive technology services payment policy
• Inpatient medical review and payment policy
• Laboratory and pathology payment policy
• Limited services clinics payment policy
• Long-term care acute care payment policy
• MassHealth provider preventable conditions payment policy
• Maximum units payment policy
• Medicaid fee schedule adjustment payment policy 
• Medical nutrition therapy payment policy
• Medicare fee schedule adjustment
• Member liability policy
• Modifier payment policy
• Neonatal intensive care services payment policy
• Newborn services payment policy
• Non-covered services payment policy
• Nurse practitioner payment policy
• Observation status payment policy
• Obstetrics/gynecology payment policy
• Oxygen and oxygen equipment
• Palliative care consultation payment policy
• Personal care attendant payment policy
• Physical and occupational therapy (PT/OT) payment policy
• Physician assistant payment policy
• Podiatry payment policy
• Post-operative nasal debridement payment policy
• Preoperative autologous blood donation payment policy
• Preventive services payment policy
• Radiology/diagnostic imaging payment policy
• Registered nurse first assistant payment policy
• Remote patient monitoring (formerly known as COVID-19 Remote Patient Monitoring)
• Renal dialysis services (including hemodialysis)
• Retroactive authorization requests payment policy
• Review of provider claims policy (formerly called "Provider audit")
• Sequestration payment policy
• Serious reportable events payment policy
• Skilled nursing facility payment policy
• Sleep management services payment policy
• Speech therapy payment policy
• Telehealth - Community Care
• Telehealth - MassHealth ACO
• Timely filing payment policy
• Transplant payment policy
• Transportation services payment policy
• Unlisted procedures and services payment policy
• Vaccine payment policy
• Ventricular assist devices payment policy
• Vision services payment policy
• Well baby/well child care visits payment policy