Provider Eligibility

Payment for the services described in 130 CMR 405.000 will be made only to providers of CHC services who are participating in MassHealth on the date of service. (A) In State. To participate in MassHealth, a CHC located in Massachusetts must meet the qualifications for certification or provisional certification in 130 CMR 405.405. (B) Out of State. To participate in MassHealth, an out-of-state CHC must obtain a MassHealth provider number and meet the following criteria: (1) if the center is required by its own state's law to be licensed, the center must be licensed by the appropriate state agency under whose jurisdiction it operates; (2) the center must participate in its state's Medicaid program (or the equivalent); and (3) the center must have a rate of payment established by the appropriate rate setting regulatory body of its state.