Coverage profile
Work Medicaid Massachusetts across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Medicaid Massachusetts.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicaid Massachusetts.
Other aliases
Also known as
- 100199
- 10124
- 2905
- 4491
- 4492
- 5529I
- 70001
- AID45
- CKMA1
- DMA7384
- MACAID
- MAMCD
- PTFCR
- SKMA0
- MassHealth
- Medicaid of Massachusetts (Mass Health)
- MASSACHUSETTS MEDICAID
2027 maternity billing research
When does Medicaid Massachusetts change OB/GYN billing?
Effective September 1, 2026, for prenatal services furnished before implementation of the AMA 2027 maternity coding structure, patients whose first prenatal visit following confirmation of pregnancy occurred on or after that date may have services reported using an appropriate E/M code with modifier TH. Use the listed setting-appropriate codes and document the selected E/M level based on medical decision making or total time, consistent with current CPT guidelines.
- Transition start
- 2026-09-01 — pre-implementation prenatal billing instructions
- Billing start
- 2026-09-01 — optional E/M + TH for qualifying new prenatal starts
- Published
- 2026-08
- Current As Of
- August 2026
Scope: MassHealth prenatal medical services before implementation of the AMA 2027 maternity coding structure; addressed to all providers participating in MassHealth. The bulletin does not identify individual managed-care plan implementation.
All Provider Bulletin 419: Transition to separate reporting of maternity care services. Verify the payer source before claim submission.
Frequently asked questions
Medicaid Massachusetts payer FAQs
How do I check claim status with Medicaid Massachusetts?
Providers check Medicaid Massachusetts via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
What is the payer ID for Medicaid Massachusetts?
The primary payer ID for Medicaid Massachusetts is DMA7384. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What are the 837 payer IDs for Medicaid Massachusetts?
The 837P and 837I payer ID for Medicaid Massachusetts is DMA7384 via Stedi.
What is the 835 payer ID for Medicaid Massachusetts?
The 835 payer ID for Medicaid Massachusetts is DMA7384 via Stedi.
What is the 270 payer ID for Medicaid Massachusetts?
The 270 payer IDs for Medicaid Massachusetts are DMA7384 via Stedi and 100199 via Availity.
What is the 276 payer ID for Medicaid Massachusetts?
The 276 payer ID for Medicaid Massachusetts is DMA7384 via Stedi.
What state does Medicaid Massachusetts operate in?
Medicaid Massachusetts operates in MA.
Routing reference
Medicaid Massachusetts payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Medicaid MassachusettsSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | MASource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | DMA7384Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | DMA7384Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | DMA7384Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | DMA7384Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 100199Source: Availity payer catalog · catalog dated · matched by payer name |
| 276 claim status payer IDStedi | DMA7384Source: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Medicaid Massachusetts. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer name; matched record: MEDICAID MASSACHUSETTS. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Medicaid Massachusetts phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Other stated context phone
- (781) 612-1000TUFTS ASSOCIATED HEALTH MAINTENANCE ORG
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 451-7715 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 872-0500 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 882-1178 | DentalBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(781) 612-1000 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 200-4255 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 228-8040 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 244-6224 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 279-9022 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 443-6657 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 448-6262 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 624-0756 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 639-2227 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 643-4845 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 708-4414 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 771-4097 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 950-9355 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(833) 570-6670 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(855) 444-4647 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(888) 632-3862 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(952) 912-6668 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 841-2900 |
|
Phone and fax numbers sourced directly from the payer response