Provider Central

For changes related to:

• Business and billing addresses
• Adding or closing a service site*
• Tax ID
• Ceasing business or will no longer provide services in Massachusetts
• Reporting a new DBA (doing business as name)
• Providing new services
• Adding a product to an existing contract

Complete the Update Form for Facilities.

*Note: You must also submit a provider application if:

• You are moving your only service site (even if simply changing suite numbers), OR
• You are adding a service site and you are one of the following provider types:

  Ambulatory Surgi-Center Assisted Reproductive Technology Behavioral Health Facility Behavioral Health or State Hospital Chronic or Long Term Care Hospital Community Mental Health Center Early Intervention Program Freestanding Clinical Laboratory Freestanding Sleep Study Facility/     Out of Center Testing

  Home Health Care Home Infusion Therapy Opioid Treatment Program Rehabilitation Hospital Skilled Nursing Facility Technical Diagnostic Imaging Transitional Care Unit Urgent Care Center