MassHealth Provider Resources
Effective 3/1/2020.
MassHealth has partnered with EviCore by Evernorth to provide its members with high-quality, cost-effective care. EviCore has been delegated to provide utilization management for the following programs:
- Radiology (including diagnostic ultrasound)
- Cardiovascular
- Sleep
Please note: For members with the following coverage types or enrolled in the following health plans, prior authorization is not required through EviCore.
| Coverage Types | Health Plans |
| MassHealth CarePlus | MCO |
| MassHealth Family Assistance | ACO A |
| MassHealth Premium Assistance | ACO C |
| MassHealth Limited | SCO |
| EAEDC | PACE |
Cardiovascular
Radiology
Sleep
CPT Codes
Resources
Resources
Need Help?
Registration Instructions
EviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.