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Massachusetts · MA

Billing, marketing, staffing and software for Massachusetts practices

RCM Finder supports medical practices in Massachusetts remotely, with end to end revenue cycle management, healthcare digital marketing, virtual medical assistance and a practice management system. Below are the Medicare and Medicaid details that apply in Massachusetts, with sources.

Massachusetts and major cities
BostonWorcesterSpringfieldBack to the full map

Massachusetts billing details

Each row shows its source and when we checked it. If a source changes, we update the row.

TopicWhat applies in MassachusettsSourceChecked
Medicare contractorNational Government Services (A/B MAC JK)CMS, A/B MAC Jurisdiction JKOct 20, 2026
Medicaid agencyExecutive Office of Health and Human Services (MassHealth)
MassHealth program
Official provider pageOct 20, 2026
Provider enrollment and billingEnrollment, manuals and billing guidance for Massachusetts Medicaid providersOpen the provider pageOct 20, 2026
Commercial prompt paymentUnder M.G.L. c.176G section 6, HMOs only must pay, deny with written reasons, or request more information within 45 days of receiving completed reimbursement forms, and interest of 1.5 percent per month (capped at 18 percent per year) accrues after 45 days, except on claims under fraud investigation.
M.G.L. c.176G, s. 6
malegislature.govOct 20, 2026
Medicaid timely filingMassHealth must receive an initial claim within 90 days of the service date, or within 90 days of the primary insurer's explanation of benefits date when other insurance was billed first, with later resolution limits of 12 or 18 months.mass.govOct 20, 2026
Medicaid telehealthMassHealth All Provider Bulletin 379 (October 2023) sets agencywide rules for reimbursing telehealth services, including payment parity with in-person care, effective October 1, 2023 across all MassHealth programs, and it revises and replaces Bulletin 355 and updates Bulletin 374.mass.govOct 20, 2026

Major cities in Massachusetts

We support practices in these cities and everywhere else in Massachusetts, remotely.

BostonWorcesterSpringfieldCambridge
How we work

Remote by design

No office visit needed

We support practices in every state remotely, so you do not need a local office to work with us.

Rules checked for your state

Each state page lists the Medicare contractor and Medicaid details for that state, with sources and the date we last checked.

One service or all four

Begin where the gap is biggest, whether that is payments, new patients, front-desk capacity or your software.

Massachusetts practice questions

Who processes Medicare claims in Massachusetts?

National Government Services is the Medicare Administrative Contractor (MAC) that processes Part A and Part B claims in Massachusetts (A/B MAC JK), according to CMS.

Which agency runs Medicaid in Massachusetts?

Executive Office of Health and Human Services (MassHealth) runs Medicaid in Massachusetts (the MassHealth program). The official state pages linked in the table above cover provider enrollment and billing.

How quickly must insurers pay a clean claim in Massachusetts?

Under M.G.L. c.176G section 6, HMOs only must pay, deny with written reasons, or request more information within 45 days of receiving completed reimbursement forms, and interest of 1.5 percent per month (capped at 18 percent per year) accrues after 45 days, except on claims under fraud investigation.

How long do I have to file a Medicaid claim in Massachusetts?

MassHealth must receive an initial claim within 90 days of the service date, or within 90 days of the primary insurer's explanation of benefits date when other insurance was billed first, with later resolution limits of 12 or 18 months.

Do you work with practices outside the largest cities in Massachusetts?

Yes. We work remotely, so a practice in a small town is supported the same way as a practice in Boston.

Which service should a practice in Massachusetts start with?

Start where the problem is biggest: End to End RCM if payments are slow or denials are high, Healthcare Digital Marketing if your schedule has gaps, Virtual Medical Assistance if your front desk is stretched, or a Practice Management System if your tools are scattered. Tell us about your practice and we will suggest a first step.

What should I send first?

A short description of your practice, your specialty, your main payers and the biggest problem you want fixed. Our form asks for the basics.

Free consultation

Ask about your Massachusetts practice

We will reply with the details that apply to Massachusetts and a suggested first step.

RCMFinder Master Intake Form