New Updated Version of the Orthotics and Prosthetics Payment Coverage Guideline Tool, 2024

The Executive Office of Health and Human Services (EOHHS) has amended 101 CMR 334.00: Rates for Prostheses, Prosthetic Devices, and Orthotic Devices effective April 1, 2024. These changes include revisions to the orthotics and prosthetics service codes and modifiers along with a reorganization of certain sections of the regulation.

Please reference Orthotics Bulletin ORT-9 and Prosthetics Bulletin PRT-13 at https://www.mass.gov/lists/2024-masshealth-provider-bulletins for more information.

Orthotics (ORT) and Prosthetics (PRT) providers are advised that the MassHealth ORT and PRT Payment and Coverage Guideline Tool has been updated to align with these changes on 4/11/24 and posted on the MassHealth website.

 To confirm that you are using the most recent version of the applicable Tool, go to www.mass.gov/service-details/masshealth-payment-and-coverage-guideline-tools.

 Please refer to our online MassHealth ORT and PRT Payment and Coverage Guideline Tool for further instructions regarding coverage, limits, and prior authorization requirements.

 If you have questions regarding this message, please contact the LTSS Provider Service Center at support@masshealthltss.com or call (844)-368-5184.