MassHealth Provider Billing & Claims Addresses 2025: Mailing Guide for Forms & Appeals

In 2025, understanding the correct **MassHealth provider billing & claims addresses** for claims, enrollment, prior authorizations, and appeals has never been more crucial. With updated payer rules, revised HCPCS/CPT codes, and streamlined remittance guidance, accuracy in mailing can prevent delays and denials, ensuring compliance and faster reimbursements. This comprehensive guide provides all current **MassHealth mailing addresses for claims**, provider enrollment, prior authorizations, and appeals, along with essential mailing tips and insights into staying compliant.

Essential MassHealth Mailing Addresses for Providers 2025

To streamline your operations, here’s a quick reference to the most critical **MassHealth mailing addresses** for providers in 2025:

📬 Why the MassHealth Address Matters in 2025

Reliable mailing addresses are foundational for efficient healthcare administration. They help you:

• Ensure timely claims and forms reach the correct department, minimizing delays.
• Avoid costly claim denials for misrouting, incorrect submission, or late filing.
• Stay compliant with MassHealth’s updated correspondence workflows and administrative policies.

MassHealth Claims Mailing Address for Providers

For submitting paper claims to MassHealth, ensuring you use the precise **mass health claims address** is paramount. Using the incorrect address can lead to significant processing delays and even denials, impacting your reimbursement cycle. This section focuses on the dedicated address for most provider claims.

MassHealth PO Box 7 (Non-Pharmacy Claims)

For all **MassHealth insurance mailing address for claims** (excluding pharmacy claims), providers must use:

MassHealth Customer Service Center
ATTN: Claims
**P.O. Box 7
Quincy, MA 02171**

Remember this specific **po box 7 quincy ma 02171** for your non-pharmacy submissions. For claims correspondence and inquiries, you may also use the fax number: (617) 988‑8910.

MassHealth Dental Claims Address

Providers submitting dental claims to MassHealth should use a distinct address. For **MassHealth dental claims**, please mail to:

MassHealth Dental Claims
**P.O. Box 631
Worcester, MA 01613-0631**

Ensure you distinguish between general medical claims and dental claims to prevent misdirection.

MassHealth Provider Enrollment & Prior Authorization Addresses

Managing provider enrollment and prior authorization (PA) requests efficiently requires accurate address information. These processes are crucial for ensuring services are covered and providers are properly credentialed within the MassHealth system.

MassHealth PO Box 278 (Enrollment & General PA Inquiries)

For submitting enrollment updates, general provider questions, or inquiries related to prior authorizations, use the following **masshealth provider contact** address:

MassHealth Customer Service
Attn: Provider Enrollment & Credentialing
**P.O. Box 278
Quincy, MA 02171**

This **po box 278 quincy ma 02171** is a central point for administrative correspondence. While this box handles general PA questions, specific Prior Authorization forms or requests might have dedicated electronic submission portals or alternative mailing instructions, which should always be verified on the official MassHealth website or through provider bulletins.

Prior Authorization Requests (Specific Types)

For direct submission of actual Prior Authorization forms, especially for specialized services like DME (Durable Medical Equipment) or specific behavioral health services, MassHealth often provides dedicated channels. Always consult the specific MassHealth program guidelines for the exact submission method. For DME/Orthotic/Prior Authorization billing units, you can contact the PA hotline:

Phone: (800) 862‑8341 (Mon–Fri, 8 a.m.–5 p.m.)

MassHealth Appeals Address for Providers

When a claim is denied or a decision needs reconsideration, providers must know the correct **MassHealth appeals address**. Prompt and accurate submission of appeals is vital for reversing unfavorable decisions.

For all provider appeals, including claim payment disputes or administrative appeals, please send your documentation to:

MassHealth Customer Service
ATTN: Appeals
**P.O. Box 1133
Quincy, MA 02171-1133**

While physical mailing is common, check the **MassHealth Provider Online Service Center (POSC)** for any electronic appeal submission options or specific fax numbers provided for urgent appeal correspondence.

MassHealth Contact Information

Beyond mailing addresses, knowing key contact points for MassHealth can save time and resolve issues quickly. Here’s a summary of general provider contact information:

Enrollment Center Physical Locations

For in-person appointments or walk-ins at Enrollment Centers, which may be useful for complex enrollment issues or urgent assistance:

• Quincy, MA – 100 Hancock St, 1st Floor
• Charlestown – 529 Main St, Charlestown, MA 02129
• Chelsea – 45 Spruce St, Chelsea, MA 02150
• Springfield, Taunton, Tewksbury, Worcester (refer to the official MassHealth site for current addresses)

2025 MassHealth Billing Updates—What Providers Need to Know

MassHealth implemented several key changes effective for 2025, which can significantly impact billing and compliance:

• Retroactive HCPCS/CPT Updates: Specific updates for Durable Medical Equipment (DME) and orthotics became effective in October 2024, impacting services rendered on or after this date. Providers should review official MassHealth Transmittal Letters and Provider Bulletins for detailed lists of affected codes and implementation guidance to ensure correct billing.
• Medicare Crossover Exclusions: For claims involving End-Stage Renal Disease (ESRD) and DME, Medicare crossovers must now be adjusted manually. This means providers need to be vigilant in identifying these claims and performing the necessary manual adjustments to avoid payment delays or denials from MassHealth.
• NPI Requirements for PA and Referrals: Beginning August 1, 2025, all prior authorizations and referrals will require a valid referring NPI (National Provider Identifier) that is actively enrolled with MassHealth. Practices must ensure all referring providers are properly enrolled and their NPIs are included in documentation to prevent authorization rejections.

Providers are strongly encouraged to regularly consult the official MassHealth website and subscribe to their provider bulletins for the most current and detailed information regarding these and any future billing changes.

How to Avoid Common Mailing Errors

Precision in mailing is a simple yet effective way to maintain compliance and avoid payment delays:

• Double-check the P.O. Box. Always confirm whether to use **P.O. Box 7 Quincy MA 02171** for claims, **P.O. Box 278 Quincy MA 02171** for enrollment/general PAs, or **P.O. Box 1133 Quincy MA 02171-1133** for appeals.
• Include Provider Number & NPI. For all correspondence, especially provider enrollment or PA letters, always add your MassHealth provider number and NPI.
• Use Certified Mail. For critical submissions like appeals or enrollment documentation, use certified mail with a return receipt requested. This provides a traceable record of delivery, which is essential for audit trails and dispute resolution.
• Update Physical Address. Ensure your practice’s physical location and mailing information are always up-to-date in the **MassHealth Provider Online Service Center (POSC)**. Incorrect DBA or mailing info can delay important communications like remittance advice or HCPCS notices.

Practical Mailing Workflow for Providers

1. Determine Purpose: Clearly identify if the mailing is for a claim, provider enrollment, prior authorization, appeal, or general inquiry.
2. Select Correct Address: Refer to the