How to become a Medicaid provider in Massachusetts
To bill Massachusetts Medicaid, enroll through MassHealth Provider Application Request Form (FFS) / MassHealth LTSS Provider Portal (LTSS programs); Provider Online Service Center (POSC) for enrolled providers and revalidation, run by MassHealth Provider Enrollment and Credentialing. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- MassHealth Provider Application Request Form (FFS) / MassHealth LTSS Provider Portal (LTSS programs); Provider Online Service Center (POSC) for enrolled providers and revalidation
- Steps
- 6
- Documents
- 5
- Plans listed
- 18
On this page
Massachusetts Medicaid enrollment at a glance
To bill Massachusetts Medicaid, enroll through MassHealth Provider Application Request Form (FFS) / MassHealth LTSS Provider Portal (LTSS programs); Provider Online Service Center (POSC) for enrolled providers and revalidation, run by MassHealth Provider Enrollment and Credentialing. The process has 6 steps, listed below with the documents the state asks for.
- Program
- MassHealth (Massachusetts Medicaid and CHIP)
- Fiscal agent
- MassHealth Provider Enrollment and Credentialing (PEC) unit, run with Maximus (contact pec@maximus.com); MassHealth does not name a separate fiscal agent on its enrollment pages
- Application fee
- MassHealth charges the fee ($750 for 2026) only to acute, chronic, psychiatric and semi-acute inpatient hospitals, ICF-MR state schools and skilled nursing facilities not in Medicare, unless already paid to Medicare or another state. It is paid online (no paper checks), is non-refundable, and the payment confirmation goes with the application. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
- Fingerprinting
- MassHealth's high-risk types include adult foster care and group adult foster care providers, and newly enrolling continuous skilled nursing agencies, DME, home health, hospice, nursing facility, orthotics, oxygen/respiratory and prosthetics providers, plus any provider meeting federal high-risk criteria. These providers and their 5%+ owners get local and national fingerprint checks after MassHealth notifies them. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.
- Site visit
- MassHealth's moderate-risk types (for example, those same agencies once enrolled, independent labs, IDTFs, mental health centers, physical therapists and ambulance providers) may get unannounced site visits from Medicare, MassHealth or both. MassHealth also has CMS-approved enrollment moratoria on new adult foster care (extended July 17, 2026) and adult day health (from May 19, 2026) agencies. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.
- Revalidation
- MassHealth contacts providers when revalidation is due; providers then have 45 days to finish in the POSC, including an online attestation and, for non-Medicare providers, a Federally Required Disclosures Form. Providers that do not finish face sanctions or termination. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
- Provider manual
- Provider manual
Steps
- Review the MassHealth regulations and provider manual for the provider type
- Request an application through the Provider Application Request Form (LTSS providers use the LTSS Provider Portal; dental and ORP have separate routes)
- Complete the application MassHealth emails you, with the Federally Required Disclosures Form
- Pay the application fee online if required and attach the confirmation
- Complete fingerprinting/site visit if notified
- Contract separately with the ACOs/MCOs whose members you want to serve
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Most MassHealth members are in Accountable Care Organizations or the MCO. Accountable Care Partnership Plans pair primary care providers with one health plan that builds the full network; Primary Care ACOs contract with MassHealth directly. Providers enroll with MassHealth through PEC and join plan networks plan by plan; MassHealth's pages describe no centralized credentialing for ACO/MCO networks. Centralized credentialing: no (not described).
- Plans (state list)
- Fallon Health – Atrius Health Care Collaborative
- Berkshire Fallon Health Collaborative
- Fallon 365 Care
- Be Healthy Partnership Plan
- WellSense Beth Israel Lahey Health (BILH) Performance Network ACO
- WellSense Community Alliance
- WellSense Boston Children's ACO
- East Boston Neighborhood Health WellSense Alliance
- WellSense Mercy Alliance
- WellSense Signature Alliance
- WellSense Southcoast Alliance
- WellSense Care Alliance
- Mass General Brigham Health Plan with Mass General Brigham ACO
- Tufts Health Together with Cambridge Health Alliance (CHA)
- Tufts Health Together with UMass Memorial Health
- Community Care Cooperative (C3) — Primary Care ACO
- Revere Health Choice — Primary Care ACO
- WellSense Essential MCO
Frequently asked questions
How do I become a Medicaid provider in Massachusetts?
To bill Massachusetts Medicaid, enroll through MassHealth Provider Application Request Form (FFS) / MassHealth LTSS Provider Portal (LTSS programs); Provider Online Service Center (POSC) for enrolled providers and revalidation, run by MassHealth Provider Enrollment and Credentialing. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Massachusetts Medicaid?
MassHealth charges the fee ($750 for 2026) only to acute, chronic, psychiatric and semi-acute inpatient hospitals, ICF-MR state schools and skilled nursing facilities not in Medicare, unless already paid to Medicare or another state. It is paid online (no paper checks), is non-refundable, and the payment confirmation goes with the application. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
How often must Massachusetts Medicaid providers revalidate?
MassHealth contacts providers when revalidation is due; providers then have 45 days to finish in the POSC, including an online attestation and, for non-Medicare providers, a Federally Required Disclosures Form. Providers that do not finish face sanctions or termination. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.