State Guide
Credentialing in Massachusetts
Enrollment guides for 46 payers operating in Massachusetts.
What actually differs in Massachusetts
Credentialing advice written for "most states" tends to be wrong here in specific, expensive ways. These are the rules that only apply in Massachusetts.
- MassHealth enrollment (POSC/MMIS) + 2026 revalidation change
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MassHealth enrollment runs through the Provider Online Service Center (POSC) on the MMIS platform, then providers join delivery-system networks (ACOs, MCOs, or the PCC Plan). Effective July 1, 2026, the revalidation process changed: providers review and submit FFS Provider Directory information during revalidation, and non-Medicare-participating individual providers no longer log into POSC to attest. They use a secure web link in the revalidation email. Missing the channel change means a lapsed enrollment.
Mass.gov New MassHealth Providers + Message Text June 2026 via kb/states/ma.md · checked Jul 2026
- MBHP (Carelon) statewide vendor + per-plan variation
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Massachusetts routes much Medicaid behavioral health through one statewide vendor, the Massachusetts Behavioral Health Partnership (MBHP), operated by Carelon, covering 430,000+ members across the PCC Plan and several ACOs. But it is not uniform: other ACOs and the MCOs manage BH through their own networks or their own Carelon contracts, so a clinician credentialed with MBHP alone will still be denied by plans running their own BH networks. Map the expected member panels and credential per delivery system.
Mass.gov MBHP Behavioral Health Benefit via kb/states/ma.md · checked Jul 2026
- Unlicensed clinicians render in clinics only (center bills) 130 CMR 429.424; 429.423; 462.404
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Massachusetts is the 'unlicensed-clinicians-in-clinics' state: 130 CMR 429.424 lets mental health centers bill for services by post-graduate unlicensed social workers, post-master's mental health counselors and MFTs, psychology post-docs and interns, and even second-year clinical-track interns, under Direct and Continuous Supervision (130 CMR 429.423), with the supervising clinician primarily responsible and supervisor review documented in every chart. The other door is bolted: independent MassHealth enrollment (130 CMR 462.404) requires an independent-level license (LICSW/LMHC/LMFT) AND Medicare participation, an unusual requirement, with no associate tier.
130 CMR 429.424 (reg text) via kb/states/ma.md · checked Jul 2026
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Get started freeWho Runs Massachusetts Medicaid Provider Enrollment
50-state researchEnrollment Portal
POSC (Provider Online Service Center)
Operated By
Maximus (enrollment and credentialing)
Platform
newMMIS / POSC
Maximus has operated MassHealth provider enrollment and credentialing under the Business Support Services contract since October 2021, while day to day transactions still run on the legacy POSC portal. Two different organizations touch your application depending on the step.
From PayerReady's 50-state Medicaid enrollment platform research, verified July 2026. Portal contracts change; where an operator is in transition or not publicly confirmed, we say so rather than guess.
Aetna
Aetna (CVS Health)
Timeline: 90-150 days
CAQH Required
UnitedHealthcare
UnitedHealthcare
Timeline: 45-90 days
CAQH Required
Cigna Healthcare
Cigna Healthcare
Timeline: 45-60 days
CAQH Required
Anthem / Elevance Health
Anthem (Elevance Health)
Timeline: 45-90 days
CAQH Required
Humana
Humana
Timeline: 45-90 days
CAQH Required
Centene Corporation
Centene
Timeline: 60-90 days
CAQH Required
Molina Healthcare
Molina Healthcare of Massachusetts
Timeline: 60-90 days
CAQH Required
Blue Cross Blue Shield of Massachusetts
Timeline: 60-120 days
CAQH Required
MassHealth
Timeline: 30-90 days
Molina Healthcare (Medicaid)
Molina Healthcare (Medicaid)
Timeline: 30-60 days
CAQH Required
TRICARE
Timeline: 30-90 days
TRICARE East Region (Humana Military)
Timeline: 30-60 days
CAQH Required
CHAMPVA
CHAMPVA (VA Office of Integrated Veteran Care)
Timeline: 14-45 days
Delta Dental
Delta Dental
Timeline: 90-120 days
Cigna Dental
Cigna Dental
Timeline: 45-90 days
CAQH Required
MetLife Dental
MetLife Dental
Timeline: 60-120 days
Guardian Dental
Guardian Dental
Timeline: 60-90 days
Aetna Dental
Aetna Dental
Timeline: 60-120 days
CAQH Required
United Concordia
United Concordia Dental
Timeline: 45-90 days
CAQH Required
DentaQuest
DentaQuest (a Sun Life company)
Timeline: 30-60 days
MCNA Dental
MCNA Dental
Timeline: 30-60 days
Liberty Dental Plan
LIBERTY Dental Plan
Timeline: 10-90 days
Dental Network of America
Timeline: 60-90 days
VSP Vision Care
VSP Vision Care
Timeline: 30-60 days
EyeMed Vision Care
EyeMed Vision Care
Timeline: 30-60 days
Davis Vision
Davis Vision (Versant Health / MetLife)
Timeline: 30-60 days
Spectera / UHC Vision
Spectera (UnitedHealthcare Vision)
Timeline: 30-60 days
Optum Behavioral Health
Optum Behavioral Health (United Behavioral Health)
Timeline: 30-45 days
CAQH Required
Carelon Behavioral Health
Carelon Behavioral Health (formerly Beacon Health Options)
Timeline: 30-60 days
CAQH Required
Magellan Health
Magellan Behavioral Health
Timeline: 30-60 days
CAQH Required
Evernorth Behavioral Health
Evernorth Behavioral Health (formerly Cigna Behavioral Health)
Timeline: 30-60 days
CAQH Required
Workers' Compensation
Timeline: 14-60 days
National Government Services (Jurisdiction K/J6)
Timeline: 60-90 days
Noridian Healthcare Solutions (DME A/D)
Timeline: 60-120 days
UnitedHealthcare Community Plan
UnitedHealthcare Community Plan
Timeline: 30-60 days
CAQH Required
Anthem Blue Shield
Timeline: 60-90 days
CAQH Required
Blue Cross Blue Shield
Timeline: 60-90 days
CAQH Required
Carelon
Timeline: 60-90 days
CAQH Required
Centene Corporation
Wellcare (a Centene company)
Timeline: 60-90 days
CAQH Required
Community Plan
Timeline: 60-90 days
CAQH Required
Compsych
Timeline: 60-90 days
CAQH Required
Medicaid
Timeline: 60-90 days
CAQH Required
Medicare
Timeline: 60-90 days
CAQH Required
Medicare Fee-for-Service (CMS)
Timeline: 45-120 days
Megellan
Magellan Behavioral Health
Timeline: 60-90 days
CAQH Required
MultiPlan
MultiPlan / Claritev (PHCS Network)
Timeline: 60-90 days
CAQH Required
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.
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