MassHealth PA-1 Prior Authorization Request

How to submit it

Enter the request in the POSC. Providers with an approved paper waiver mail the PA-1 and attachments to the MassHealth address for basic medical services or the separate address for long-term services and supports, both given in the instructions.

Who pays

Approval does not guarantee payment, which remains subject to the member's current eligibility, other insurance and MassHealth program restrictions.

• Compliant standard requests get a decision in seven days. If MassHealth agrees the standard timeframe could seriously risk the member's life or health, an expedited decision comes in 72 hours.
• Item 3 sorts the request as basic medical (such as hearing, vision or physician services) or long-term services and supports (home health, PCA, DME, oxygen, therapy).
• Sign by hand and scan, or use DocuSign or Adobe Sign; a typed signature is not accepted. Leaving items 1 to 22 incomplete risks delays under 130 CMR 450.303(B).
• Attach documentation that clearly supports medical necessity, such as x-rays, admission notes or photographs, and mark item 18. MassHealth ACOs and MCOs run their own PA processes.

Prior Authorization Request

Massachusetts Executive Office of Health and Human Services (MassHealth) takes this form through its online services or your EMR, so there is no PDF to fill. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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