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Hospitals/Facilities/Labs
 Clarification
This page applies to ONLY the following provider types.
  • Ambulance
  • Ambulatory Surgi-Center
  • Assisted Reproductive Technology
  • Behavioral Health Facility
  • Behavioral Health Hospital
  • Cardiac Rehabilitation
  • Chronic/Long Term Care Hospital
  • Clinical Laboratory
  • Community Mental Health Center
  • Dialysis
  • Durable Medical Equipment
  • Early Intervention
  • Home Health Care
  • Home Infusion Therapy
  • Hospice
  • Independent Physiologic and Diagnostic Lab
  • Radiation Oncology Facility
  • Rehabilitation Hospital
  • Skilled Nursing Facility
  • Sleep Study Facility
  • Technical Diagnostic Imaging
  • Transitional Care Unit
  • Urgent Care Center
For changes related to You should
  • Business and billing addresses
  • Reporting a new DBA (doing business as name)
  • Providing new services
  • Adding a product to an existing contract
  • Ceasing business or will no longer provide services in Massachusetts
 Submit the Update Form for Facilities
  • Moving your ONLY service site
 Submit a provider application
  • Opening a new service site and are one of the following provider types:
    • Clinical Laboratory
    • Durable Medical Equipment
    • Freestanding Dialysis Facility
    • Freestanding Radiation Oncology Facility
    • Ground Ambulance
    • Home Infusion Therapy
    • Hospice Services
    • Independent Physiologic & Diagnostic Lab
 Submit the Update Form for Facilities
  • Opening a new service site and are NOT one of the provider types listed above
 Submit a provider application
  • Change in ownership
 Submit a Request
for Consent to Assignment Form
Related Content

Related Content

CAQH Provider Data Portal
Credentialing Q & As
Credentialing and recredentialing
Standardized Provider Information Change Form
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