Medicaid

How to Get Credentialed with MassHealth in Massachusetts

Network: Open
30-90 Days

Quick Overview

Timeline

30 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

Massachusetts-Specific Requirements

Massachusetts Medicaid (MassHealth) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the EOHHS (Executive Office of Health and Human Services) POSC (Provider Online Service Center) portal. (3) Submit application with MA state license, proof of malpractice insurance, and required documentation. (4) Background check including state CORI and federal criminal history is required for all providers. MassHealth operates managed care through MCOs and Accountable Care Organizations (ACOs). Behavioral health providers accepted include LMHC, LICSW, LMFT, and Licensed Psychologist with active Massachusetts licensure. Revalidation is required every 5 years.

Medicaid Information — Massachusetts

Agency: Massachusetts EOHHS

Program: MassHealth

Portal: https://newmmis.ehs.state.ma.us

Phone: 1-800-841-2900

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Massachusetts.

2

Prepare Your Application

Complete MassHealth's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to MassHealth.

4

Track & Follow Up

Credentialing typically takes 30-90 days. Monitor your application status and respond promptly to requests for additional information.

Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

MassHealth Provider Enrollment

Required
Online Open →

Contact Information

Provider Enrollment

National

1-800-841-2900

General Provider Inquiries

National

1-800-841-2900

Quick Links

Provider Portal

Need Help?

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Other Payers in Massachusetts

Aetna UnitedHealthcare Cigna Healthcare Anthem / Elevance Health Humana Centene Corporation Molina Healthcare Blue Cross Blue Shield of Massachusetts Molina Healthcare (Medicaid) TRICARE
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