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Nursing Facility Bulletin 190: Updates to Transition to CMS OBRA MDS 3.0 Assessments for Nursing Facility Fee-for-Service Payments
MassHealth·MA · Geriatrics·Specialty Services
Effective date
Jan 21, 2025
We identified it
Jun 18, 2026
Summary
MassHealth has updated requirements for nursing facility billing, transitioning from Management Minutes Questionnaire (MMQ) to CMS OBRA MDS 3.0 assessments to determine resident acuity and payment rates. This bulletin supersedes previous guidance from September 2023 and outlines specific MDS assessment schedules, submission requirements, and payment determination processes for MassHealth nursing facility fee-for-service claims.
Action Required
By January 21, 2025: Nursing facility billing teams must ensure all MDS assessments include both MassHealth provider ID and MassHealth member ID. Facilities must follow CMS MDS 3.0 assessment schedules (admission, quarterly, annually, and significant changes) and verify data import accuracy using weekly MDS Submission Success Report (ELG-402) and Error Report (ELG-404) available every Wednesday. Submit modified assessments to correct any errors or missing IDs to maintain MassHealth payment eligibility.