Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 455.000 - Urgent Care Clinic Services
Section 455.404 - Provider Eligibility
Universal Citation: 130 MA Code of Regs 130.455
Current through Register 1531, September 27, 2024
Payment for the services described in 130 CMR 455.000 will be made only to providers of UCC services who are participating in MassHealth on the date of service.
(A) In-State. To participate in MassHealth, a UCC located in Massachusetts must
(1) operate under a
clinic license issued by the Massachusetts Department of Public Health pursuant
to 105 CMR 140.000: Licensure of Clinics; and
(2) have a signed provider contract with the
MassHealth agency.
(B) Out-of-State. To participate in MassHealth, an out-of-state UCC must obtain a MassHealth provider number and meet the following criteria:
(1) if the clinic is
required by its own state's law to be licensed, the clinic must be licensed by
the appropriate state agency under whose jurisdiction it operates;
(2) the clinic must participate in its
state's Medicaid program (or the equivalent); and
(3) meet the conditions set forth in
130 CMR
450.109: Out-of-state
Services.
Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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