Provider Eligibility: Out of State

To participate in MassHealth, an out-of-state therapy provider must (A) participate in the Medicaid program in the state in which it is located; (B) be licensed by and be in good standing with their state’s licensing authority; (C) provide therapy services consistent with the provisions of 130 CMR 450.109: Out-of-state Services; (D) obtain a MassHealth provider number before providing therapy services; (E) provide services in accordance with 130 CMR 432.411: Payable Services; and (F) notify the MassHealth agency in writing within 14 days of any change in any of the information submitted in the provider application in accordance with 130 CMR 450.223(B): Provider Contract: Execution of Contract, including, but not limited to, change of ownership, change of address, and addition or deletion of a branch office. As set forth at 130 CMR 432.411(E) and (F), the MassHealth agency pays for services provided by out-of-state therapists or by out-of-state PTAs, OTAs, and SLPAs when consistent with Medicaid requirements regarding therapy assistants in the state in which they are located, subject to the supervision requirements of 130 CMR 432.000.