Over 2 million Massachusetts residents are covered by MassHealth, yet fewer than half of the state’s dental offices accept MassHealth patients, resulting in limited access to dental care.
With only 43% of dental offices in Massachusetts in network with MassHealth, the state falls behind several other states, such as Michigan (48%), Minnesota (55%), and Delaware ( 76%).
Providers cite low reimbursement rates as a primary cause, “it’s one of the main reasons a lot of offices don’t take MassHealth. Fees are very low and don’t cover the actual services that they provide,” Melrose Dental Group said.
MassHealth Coverage
MassHealth, Massachusetts’ Medicaid program that provides dental and health coverage for low income to moderate residents, covers most services depending on income and adjusted premiums.
MassHealth, jointly funded by the federal and state governments, received $22.2 billion from the state’s FY2026 budget.
Providers submit claims through MassHealth’s online portal, which includes patient information, procedure codes, tooth information, and provider details. Claims must be submitted within 90 days. MassHealth will then approve or deny the claims. Once approved, reimbursements are issued within 30 to 60 days.
What happens when Dental Offices reject MassHealth Patients
Dental offices that reject MassHealth patients before notifying MassHealth, as required under state regulations, will be fined by the Mass. Attorney General’s Office. Practices must update their status with MassHealth in order to legally stop taking MassHealth patients.
Previously, the AGO reached a settlement with Brighton Dental Office in 2021, afternddda enp dpnpoy e it found that “the dental practice had been refusing to accept new MassHealth patients between January 1, 2020 and September 30, 2020,” according to Mass.gov.
“Under GL chapter 12, section 11N, the AGO has authority to monitor trends in the health care market, including patient access issues” , said the Massachusetts Attorney General’s Office.
Under the Federal Medicaid Act (Title XIX of the Social Security Act), states must ensure adequate access to dental care for children.
If more dental offices continue to stop accepting MassHeath, Massachusetts could be found out of compliance with federal standards and be open to potential lawsuits.
Dr. Steven Spitz, president of the Massachusetts Dental Society said, “Dentists are not penalized if they decide to close their practice to new MassHealth patients. Dental practices have the flexibility to determine their level of participation in the program, with their main priority always being to provide quality patient care.The long-term strength of the program depends on making participation straightforward, sustainable, and manageable.”
BINJ.News received no replies to requests to MassHealth’s press office for comment.
Impact on Patients
Although the MassHealth provider directory lists Harmony Dental in Boston as participating and accepting new patients insured by MassHealth, as of March 4, 2026, staff at the office said by phone that “[the practice] does not do that.”
For patients insured through MassHealth, limited provider participation and inconsistencies result in difficulty finding coverage nearby, and pressure them to travel long distances to receive care.
“It’s hard, you know, I feel like it’s so out of the way,” said David Dos Santos, an Everett resident who is insured by Masshealth.
The shortage can possibly lead to delays in preventive care, often compromising infections, untreated cavities, and gum disease.
“I believe it’s prolonging my periodontal disease,” said a patient who did not want to be named.
State Compliance
There are no current administrative actions to prevent the declining numbers of dentists working with MassHealth.
“Although dentists are focused on serving patients, there is some uncertainty with the program due to historic issues with benefit reductions, reimbursement delays, administrative challenges, and low reimbursement levels. These issues raise concerns about network stability and could jeopardize provider participation moving forward,” said Dr. Spitz.
Initiatives have been proposed to encourage dental offices to accept MassHealth, such as the testimony in 2025 from Dr. Kadambari Rawal, a clinical associate professor of general dentistry at Boston University, who advocated for the legislation of “Take 10,” a bill that would incentivize dental offices that participate. Take 10 is pending approval in the Massachusetts legislature.
“[I believe] dentists should be incentivized to accept more MassHealth patients into their practices to reduce burnout and offset the administrative burden of filing claims,” Dr. Rawal said in front of the legislature’s Joint Committee on Healthcare Financing, according to Henry M. Goldman School of Dental Medicine.
MassHealth increased reimbursement rates in rural areas in Massachusetts including Berkshire, Dukes, Barnstable, Hampshire, and Franklin counties, but none of the increases has targeted providers closer to Boston, according to a 2025 report from the Executive Office of Health and Human Services.
Gov. Healey Proposed $1,000 cap
Gov. Healey has proposed a $1,000 annual cap on MassHealth coverage of adult dental procedures in her FY27 budget proposal as part of an effort to curb rising Medicaid spending—though the pediatric dental coverage would remain uncapped. Healey has stated that President Donald Trump has cut over $3 million from Massachusetts federal funding.
“We can’t bankrupt our state while we try to address the federal shortfalls,” said Gov.Healey during a January 28 press conference.
This proposal has raised concerns in the dental community since MassHealth currently does not impose an annual cap.
Dr. Spitz of the Mass. The Dental Society called it “antiquated and insufficient to meet current care demands.”
State officials said this is about controlling health costs. The cap was designed to save the state up to $120 million, according to Boston 25 News.
Spitz disagreed, “Patients will be compelled to pay out of pocket or delay vital treatment, undoubtedly increasing visits to already overburdened emergency rooms.”
He added, “The $1,000 cap will also affect the Boston-area dental school clinics, which primarily serve MassHealth patients. Their ability to treat patients will be restricted, resulting in financial and educational impacts on the clinic.“
There is an ongoing petition fighting against the cap as the proposal heads to lawmakers who will decide if it remains in the final budget.
Spitz noted, “The MDS urges lawmakers to maintain comprehensive adult dental coverage within MassHealth and reject the proposed cap to ensure every patient across the Commonwealth can continue to access quality dental care. If practices can’t provide quality care to their patients because of this cap, leaving the program is a possibility. We can only speculate how patients and providers will be affected.”
