Masshealth prior authorization 2025

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It typically takes 24 to 72 hours. You may check the status of your prior authorization request on the prior authorizations page. You may also contact your doctors office directly.
You may be able to speed up a prior authorization by filing an urgent request. If you cant wait for approval, you may be able to pay upfront at your pharmacy and submit a reimbursement claim after approval.
How to request You can use our Prior Authorization Forms for Pharmacy Services page to find the right PA form. Search for the right form by either: You can also go directly to the MassHealth Drug List A - Z tool to search by drug name. You can also search for the right forms by using the Therapeutic Class Tables.
At the federal level, earlier this year the Centers for Medicare and Medicaid Services (CMS) issued a final rule that will, among other things, require payers to send prior authorization decisions within 72 hours for urgent requests and within a week for nonurgent requestsstarting in 2026.
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