The purpose of this option is to provide existing MassHealth providers and their authorized users with visibility into their current relationship with MassHealth. This option also provides visibility into providers who are no longer currently enrolled as MassHealth providers.

Only the MassHealth provider and those authorized agents on the behalf of the provider can use this option.

All individuals, entities, or group practices enrolled in MassHealth will have a Provider ID/ Service Location (PID/SL) that is unique to them.

All individuals who intend to participate within a group practice must be enrolled as Fee for Service providers and linked to the groups where they will practice.
All other individual providers that meet the Ordering, Referring, and Prescribing provider requirements are required to participate as ORP in the MassHealth program. This will be outlined as a condition of obtaining and maintaining your license to practice in Massachusetts, if you meet these criteria.

Only services rendered by individual providers or facilities enrolled as Fee-for-Service (FFS) can be billed to MassHealth. Services rendered by an individual FFS provider may need to be billed through an enrolled PT-97 Group Practice Organization depending on their set-up.
Please refer to MassHealth regulations 130 CMR 450.000: Administrative and Billing Regulations for more information.

Ensure you are using all the available provider identifiers (PID/SL, NPI, Corporate FEIN) as part of your search and that the provider is not participating only within MassHealth's Long-Term Services & Support (LTSS), Dental, or Managed Care Plans.
Note, the provider's application may still be in process with MassHealth; check the Provider Application Status option to obtain a status on the application.

Visit the Maintaining MassHealth Provider File Information page for guidance on how to update a provider's enrollment information.
Note: MassHealth should be notified of any material changes to a provider's enrollment information at least 14 days prior to the change.
All MassHealth providers should maintain adequate documentation and records, such as their MassHealth PID/SL, in accordance with MassHealth regulations 130 CMR 450.205.

A new application is required in order to re-establish the provider's enrollment with MassHealth; visit the Apply to become a MassHealth Provider page for more information on applying to MassHealth.

Providers can be due to be disenrolled for a various number of reasons such as:

1. No longer meeting participatory requirements
2. Voluntarily withdrawing
3. Failing to revalidate

You will receive a notice of disenrollment listing the reason which is sent to the provider's DBA address on file with MassHealth.

Providers can submit a letter confirming their intent to terminate their relationship with MassHealth by faxing or mailing:
MassHealth Provider Enrollment
P.O. Box 278
Quincy, MA 02171
Fax: (617) 988-8974

Enter the Application Tracking Number (ATN) of the application you are searching for; you can also search for an application using the applicant's National Provider Identifier (NPI).

The grid below provides descriptions regarding the various application statuses:

Status	Status Description
Received	MassHealth has received the application and will begin processing as soon as possible.
In-Process	The application is in-process, nothing additional is needed.
In-Process: Additional Information Needed	A submitted application was reviewed and deemed incomplete. A representative from MassHealth will have reached out to the contact person listed on the application stating what is required. A letter detailing what is required would also be mailed to the DBA address listed in the application.
In-Process: Pending License	MassHealth has received all the application forms required to enroll the applicant except for the newly issued/renewed professional licensure which was indicated to be in process.
Final Review	The application is in final processing, nothing is needed at this time.
Review Complete: Enrolled	The application has been approved and enrolled with MassHealth; ATNs in this status will also have the PID/SL and effective date issued to the provider.
Review Complete: Denied	The application is denied, the applicant will receive a MassHealth letter sent to the DBA address listed in the application stating the reason for the denial.

Upon receipt of an application, the contact listed on the application would receive an email from MassHealth PEC notifying them of the ATN.

It may take 5-10 business days for MassHealth to receive a mailed application and 2-3 business days for a faxed application. Also ensure that you are searching using NPI in addition to the ATN.

It is common for provider applications to be submitted on the behalf of the applicant by healthcare organizations they work for; the provider should confirm with any organization(s) they are employed by if the application was submitted by them.

MassHealth has a 60-day timeline to process applications, however a complete application submission will generally be processed within 30 days.
Note: MassHealth will notify you in writing of its decision about your application. You are not a participating MassHealth provider until you have satisfied the enrollment requirements and have been notified that your enrollment has been approved.

This is the date in which MassHealth received the application to begin processing.

MassHealth will notify the provider in writing of its decision about their application which will include the effective date of their enrollment. They are not a participating MassHealth provider until they have satisfied the enrollment requirements and have been notified that their enrollment has been approved. Payment will not be made for any claims submitted for services, care, or supplies furnished before the enrollment date authorized by MassHealth.

If an application is denied, the applicant will receive a MassHealth letter sent to the DBA address listed in the application stating the reason for the denial.

You can reach out to PEC@maximus.com for further assistance.