← Back to list
HCBS Waiver Provider Bulletin 28: Implementation of National Provider Identifier (NPI) Number
Act
by Dec 1, 2026
Effective date
Dec 1, 2026
Identified
Nov 7, 2026
Summary
MassHealth requires HCBS waiver providers in the ABI and MFP programs that bill MassHealth directly to obtain and use a National Provider Identifier (NPI). New providers must furnish their NPI with their initial application starting December 1, 2026, and existing providers must furnish it at their regularly scheduled recredentialing, with earlier requests made by the HCBS Provider Network Administration Unit. Beginning May 1, 2028, NPIs must appear on all claims, and claims without the billing provider's NPI will be denied.
Get alerts when payers change rules like this one
We check MassHealth and other payers every day and email you when a change matches your specialty and state.
Get MassHealth alertsPolicy Monitoring is free. No card required.
What to do
by Dec 1, 2026 · 5 steps
01Obtain an NPI through NPPES (no cost) for any ABI or MFP waiver service location that bills MassHealth directly, and furnish it with any new provider application starting that date.
02Existing providers: Furnish the NPI at the next scheduled recredentialing, or sooner if the HCBS Provider Network Administration Unit at ForHealth Consulting (855-300-7058, ProviderNetwork@umassmed.edu) requests it; the practice is disenrolled if the NPI is not provided in a timely manner.
03Billing team: Record each location's MassHealth PID/SL (for example, 1234567 89A) alongside its NPI in the provider file.
04Before May 1, 2028: Update claim submission and charge entry so the billing provider's NPI is included on every claim, and do not add a taxonomy code unless the HCBS unit instructs you to.
05Consequence: Claims billed on or after May 1, 2028 without the billing provider's NPI will be denied.
Original notice
HCBS Waiver Provider Bulletin 28: Implementation of National Provider Identifier (NPI) Number
mass.gov · Always check the source before changing claims.