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Nursing Facility Bulletin 194: Additional Updates to Transition to CMS OBRA MDS 3.0 Assessments for Nursing Facility Fee-for-Service Payments
MassHealth·MA · Geriatrics·Specialty Services
Effective date
Jul 1, 2025
We identified it
Jun 18, 2026
Summary
MassHealth has updated requirements for nursing facilities to use CMS OBRA MDS 3.0 assessments for fee-for-service payments, effective July 1, 2025. Facilities must include both MassHealth provider ID and member ID on all MDS assessments and follow specific submission timelines to receive payment.
Action Required
Immediately: Nursing facility billing teams must ensure all MDS assessments include both MassHealth provider ID and MassHealth member ID. Review weekly MDS Submission Success Report (ELG-402) and MDS Submission Error Report (ELG-404) available every Wednesday. Submit modified MDS assessments within 14 days for any errors identified. Follow CMS MDS 3.0 RAI Manual submission schedules - admission assessments within 14 days, quarterly assessments within 92 days, with 21-day grace period for MassHealth payment acceptance.