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MassHealth Drug List


COVID-19 Pharmacy Program Emergency Response

Link to MassHealth Pharmacy Program COVID-19 information. Please note, guidance will be updated as needed and as additional information is available.

Introduction to MassHealth Drug List 

Information about the MassHealth Drug List and updates to the list. Sign up to receive e-mail notification of when updates to the MassHealth drug list are posted on the Web.

Upcoming and Recent Updates 

Link to the most recent updates to the MassHealth Drug List. May be subject to change.

Prior Authorization Forms for Pharmacy Services 

Link to all Prior Authorization forms for MassHealth Pharmacy Services.

MassHealth Supplemental Rebate/Preferred Drug List

Link to the list of drugs preferred by MassHealth based on supplemental rebate agreements between MassHealth and drug manufacturers. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing a non-preferred drug within a therapeutic class.

MassHealth ACPP/MCO Uniform Preferred Drug List

Link to the list of therapeutic classes for which preferred drugs have been designated and the obligations of MassHealth Accountable Care Partnership Plans and Managed Care Organizations with respect to those classes.

MassHealth Brand Name Preferred Over Generic Drug List

Link to the list of brand name drugs that MassHealth prefers over their generic equivalents because the net cost of the brand name drug adjusted for rebates is lower than the net cost of the generic equivalent. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing the non-preferred drug generic equivalent.

MassHealth Over-the-Counter Drug List

Link to a list of the drugs that are the only nonlegend drugs, with the exception of insulins, that are covered by MassHealth without prior authorization.

MassHealth Non-Drug Product List

Link to a list of non-drug products that MassHealth pays for through the Pharmacy Online Processing System (POPS).

MassHealth Pharmacy Covered Professional Services List

Link to the list of the professional services that MassHealth pays for through the Pharmacy Online Processing System (POPS).

MassHealth Acute Hospital Carve-Out Drugs List

Link to the current list of “APAD Carve-Out Drugs” and “APEC Carve-Out Drugs” for which a Hospital must obtain prior authorization (PA) from MassHealth. Please note that these treatments will be subject to monitoring. Other requirements also apply.

Medicare Part D Exclusion Drug List 

Link to a list of drugs that Medicare Part D excludes from prescription coverage, but may be covered by MassHealth.

MassHealth Pharmacy Initiatives and Clinical Information 

Link to the Concomitant Opioid Benzodiazepine, Pediatric Behavioral Health Medication, Hospital Outpatient Prior Authorization, Opioid and Pain, and Second-Generation (Atypical) Antipsychotic Initiatives. Also includes the CAR-T Monitoring Program and Zolgensma Monitoring Program description.

Controlled Substances Management Program (CSMP): Criteria for Member Enrollment

Controlled Substance Management Program (CSMP): Pharmacy Selection Form

Quick Reference Guide

Please note that this document does not represent the complete MassHealth Drug List.

10 Tips for a Good Night's Sleep

The MassHealth Drug List Downloads 

Download the current MassHealth Drug List and the previous 5 updates to the MassHealth Drug List in PDF or DOC format.

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