Provider Eligibility

(A) In State. Each program is eligible to participate only if the program is: (1) for provider types eligible for such enrollment, enrolled as a Medicare provider; (2) licensed or approved by the Massachusetts Department of Public Health to provide the appropriate substance use disorder treatment service pursuant to 105 CMR 164.000: Licensure of Substance Use Disorder Treatment Programs and as defined in 130 CMR 418.404 (A); (3) enrolled and actively participating with the MassHealth agency as a billing provider, as evidenced by the issuance of a Provider Identification and Service Location (PIDSL) number for the provision of substance use disorder treatment services at that location. (B) Out of State. Each out-of-state program is eligible to participate only if the program: (1) meets the following criteria: (a) is licensed by the appropriate state agency under whose jurisdiction it operates to provide equivalent substance use disorder services; (b) participates in its own state's medical assistance program or its equivalent; and (c) has a rate of reimbursement established by the appropriate rate setting regulatory body of its state. (2) for provider types eligible for such enrollment, is a Medicare-participating provider; and (3) is enrolled and actively participating with the MassHealth agency as a provider of substance use disorder services, and obtains a MassHealth PIDSL number.