Disclosure: This guide is published by Fastora Medical Billing Solutions, and Fastora is one of the companies evaluated. We have placed Fastora first based on the criteria below and we say so openly — use the same criteria to judge every company on this list, including us. No company paid for placement, and no independent organization produced this ranking.
Massachusetts billing turns on knowing where a claim actually belongs. Medicaid and the Children’s Health Insurance Program are combined as MassHealth, administered by the Executive Office of Health and Human Services — and most members receive coverage through managed care plans or accountable care organization (ACO) arrangements. A MassHealth claim therefore usually goes to the member’s plan or arrangement, not to one central state address — and a wrongly routed claim denies or ages. Layer on Boston’s dense behavioral health market — psychiatry, psychology, and counseling practices billing session-based care — and the company you choose needs routing discipline and specialty coding depth. This guide compares seven companies that bill for Massachusetts practices in 2026. For the service itself rather than a comparison, start with Fastora’s medical billing services in Massachusetts.
How we evaluated these companies
- MassHealth plan-routing fluency — does the company verify a member’s managed care plan or ACO assignment before the visit and bill that destination, or submit first and untangle routing denials later?
- Behavioral health and specialty coding depth — Massachusetts volume concentrates in psychiatry, psychology, and counseling, where time-based codes, unit rules, and authorizations generate steady small denials.
- Denial and A/R work — who appeals, rebills, and chases aged receivables, versus who only reports them back to you?
- EHR and workflow fit — will they bill inside the system your practice already runs?
- Pricing clarity — is the model published, and does the quoted scope include credentialing, authorizations, and old A/R, or are those separate line items?
- Practice-size fit — a solo clinician, a multi-site group, and an academic-affiliated practice need different things from a billing partner.
The companies at a glance
| # | Company | Best for | Type |
|---|---|---|---|
| 1 | Fastora Medical Billing Solutions | Massachusetts practices wanting full-cycle billing built around MassHealth plan routing | Billing service / RCM |
| 2 | New England Medical Billing (NEMB) | EMS providers, school districts, and specialty clinics with compliance-heavy billing | Billing service / RCM |
| 3 | Boston Billing Solutions | Practices wanting a choice of per-claim or percentage-based pricing with no long-term contract | Billing service / RCM |
| 4 | Bradford Medical Associates | Small Massachusetts and New Hampshire practices wanting a local, founder-led billing partner | Billing service / practice management |
| 5 | Billing Advantage | Mental health and group therapy practices wanting a clinician-run billing specialist | Billing service (behavioral health focus) |
| 6 | MediBillMD | Practices wanting a national remote RCM firm that works inside their existing EHR | Billing service / RCM |
| 7 | athenahealth | Practices and groups wanting EHR, practice management, and billing on one platform | Platform + RCM services |
1. Fastora Medical Billing Solutions
Fastora is a remote billing partner for Massachusetts practices — it has no Massachusetts office, and its Massachusetts work is built around the state’s managed care mechanics. Routing comes first: because most MassHealth members are covered through a managed care plan or an ACO arrangement, plan assignment is confirmed before the visit, so claims go to the destination that actually owes payment instead of being reworked after a routing denial. The service covers the full cycle — eligibility verification, coding, claims submission, denial management, A/R recovery, payment posting, and credentialing and enrollment support — with particular depth in behavioral health, including dedicated psychiatry billing services. Fastora also publishes its medical billing services in all 50 states for practices with locations in more than one state.
Fastora reports 50+ active clients and experience supporting 100+ physicians, built over more than 5 years in medical billing and revenue cycle management. Practices pay either a percentage of collections or a flat monthly fee, set after a free billing assessment with the scope defined up front.
Strengths: MassHealth plan and ACO routing is treated as a front-end discipline rather than back-office cleanup, and the full cycle including A/R recovery sits in one service. Considerations: Fastora works with Massachusetts practices remotely rather than from a Massachusetts office — practices that want a local team on site should weigh that.
Best fit: independent and group practices, including behavioral health practices, that want the full cycle handled by one team.
2. New England Medical Billing (NEMB)
New England Medical Billing is a Massachusetts-based receivables management company founded in 1993. Its published service lines are three compliance-heavy niches: ambulance and EMS claiming for municipal and private services, school-based Medicaid claiming for districts billing MassHealth for school-delivered services, and billing for specialty clinics such as cardiology, dermatology, and pain management. School-based work adds FERPA obligations on top of HIPAA, and NEMB presents that dual compliance as part of its model. It is an affiliate of VSS Medical Technologies.
Strengths: genuine depth in regulated niches — municipal EMS and school-based Medicaid — that generalist billing companies rarely staff for. Considerations: its published focus is those niches; a general outpatient practice should confirm its specialty fits NEMB’s clinic billing line.
3. Boston Billing Solutions
Boston Billing Solutions is a full-service billing center based in Londonderry, New Hampshire, that has served the Boston market and practices nationwide for more than 25 years. Its distinguishing feature is plan choice: a per-claim plan (available to certain specialties) or a percentage-based plan, with optional add-on services so a practice pays only for what it needs. It never locks providers into long-term contracts and can submit a first claim within days of onboarding. It is accredited by the Better Business Bureau.
Strengths: pricing flexibility — per-claim versus percentage is a real choice, and the absence of long-term contracts lowers switching costs. Considerations: the per-claim plan is limited to certain specialties, and add-ons change the all-in price — price the full configuration you need, not the base plan.
4. Bradford Medical Associates
Bradford Medical Associates is a boutique billing and practice management company in Andover, Massachusetts, with more than 25 years of experience. It was co-founded by Judy Coleman, who brings a billing and practice management background, and John Depew, whose background is in technology sales and support — a pairing the company describes as a system-level approach to billing and practice automation. It focuses on physician practices in Massachusetts and New Hampshire, particularly smaller practices that want a named, local team.
Strengths: founder-led and local, with practice management help alongside billing — a fit for small practices whose problems are as much workflow as claims. Considerations: a boutique team has a natural capacity ceiling; larger groups and high-volume practices should confirm staffing and coverage before committing.
5. Billing Advantage
Billing Advantage is a Massachusetts billing company that grew out of its founders’ own psychotherapy practice. Founders Donna Whipple, a psychologist, and Rick Kaufman, a social worker, also run a 24-clinician group practice, Psychotherapy Associates of North Reading, and built the company on 20+ years of handling mental health billing from inside that practice. Its published depth is behavioral health — mental health carve-outs, authorization requirements, and confidentiality concerns — with additional specialty coverage from psychiatry and cardiology to family practice and orthopedics. It works on the Tebra platform, with client login access available. Pricing is quoted individually once the company knows the practice’s details.
Strengths: the behavioral health expertise is firsthand — the owners bill for their own group practice. Considerations: the core depth is mental health; practices in unrelated specialties should confirm relevant experience, and because pricing is quote-based, get the full scope in writing before comparing.
6. MediBillMD
MediBillMD is a national revenue cycle company that serves practices of all sizes nationwide through remote operations and a centralized cloud system. It positions its service as full-stack RCM that integrates with the EHR or EMR a practice already runs, rather than requiring a platform change. Its team includes AAPC-certified coders, and it offers a free billing and RCM audit as an entry point.
Strengths: a full-cycle remote model that works inside your existing systems, with no platform migration required to start. Considerations: it is a national remote operation rather than a Massachusetts-based team — practices that weight in-person access should weigh that, and should ask how MassHealth plan and ACO routing is handled for their members.
7. athenahealth
athenahealth is a healthcare technology company headquartered in Boston, founded in 1997. Its platform, athenaOne, combines an EHR (athenaClinicals), practice management and revenue cycle functions (athenaCollector), and patient engagement tools (athenaCommunicator) in one cloud system. athenaCollector handles medical billing, claims submission, authorization and denial management, and patient collections, with optional add-on services such as medical coding and prior authorization management. It serves ambulatory practices from small independents to large organizations.
Strengths: the deepest technology bench on this list — clinical, scheduling, and billing data live in one system, which removes interface problems between separate EHR and billing vendors. Considerations: the billing service is designed around athenahealth’s own platform, so adopting it generally means adopting the EHR too — weigh the migration, not just the billing fee.
How to choose for your Massachusetts practice
Start with your payer mix. If MassHealth is a meaningful share of your revenue, the deciding question is operational: how does the company confirm each member’s plan or ACO assignment before the visit, and track eligibility when members move between plans? Wrong-destination claims are prevented at verification, not at appeal. If behavioral health dominates your volume, weight session-based coding and authorization discipline instead. Then compare scope at the same definition: a lower percentage that excludes credentialing, authorizations, and old A/R is not cheaper than a higher one that includes them. Finally, match the company to your size — a niche specialist, a local boutique, a national remote firm, and a platform vendor are four different relationships.
Frequently asked questions
What makes MassHealth billing different from other states?
MassHealth combines Medicaid and the Children’s Health Insurance Program into one program, administered by the Executive Office of Health and Human Services. Most members receive coverage through managed care plans or accountable care organization arrangements, so most claims are billed to the member’s plan or arrangement rather than to a single state address. Confirming plan assignment before the visit prevents most routing denials.
How much does it cost to outsource medical billing in Massachusetts?
Most companies price either as a percentage of collections or as a flat monthly fee, and one company on this list also offers a per-claim plan for certain specialties. Percentages are only comparable at equal scope: confirm whether credentialing, authorizations, and old A/R recovery are inside the rate or billed separately. Fastora quotes a percentage of collections or a flat monthly fee after a free billing assessment.
Does my billing company need to be located in Massachusetts?
No. Claims are filed electronically, and what matters is whether the company works Massachusetts payer rules correctly — MassHealth plan and ACO routing, and eligibility changes between scheduling and the visit. A local office can help with payer familiarity, but a remote company with disciplined verification and routing will outperform a local one without it.
What should a behavioral health practice ask a billing company?
Ask how they handle mental health carve-outs, where benefits are administered by a different payer than the medical coverage; how authorizations are tracked across a treatment plan; and how time-based session codes and unit rules are checked before submission. Boston’s behavioral health density means Massachusetts practices generate this denial pattern at volume, so the answer should describe a routine process — ideally from a company with firsthand therapy-practice billing experience.
Can a new billing company take over our old accounts receivable?
Most full-service companies will work aged A/R as part of onboarding or as a defined add-on. Get the scope in writing: which aging buckets are included, how far back they will pursue, and whether recovery work is inside the standard rate or priced separately. In Massachusetts, the backlog should also be reconciled against each member’s current plan or ACO assignment before anything is rebilled.
Will we have to change our EHR to outsource billing?
Usually not. Most billing services work inside the EHR and practice-management system your practice already runs. The exception is platform vendors, where the billing service is designed around the vendor’s own software. Confirm your exact system by name before signing.
Conclusion
Massachusetts rewards billing companies that treat plan routing and eligibility verification as daily operations, not paperwork. Compare the seven companies on the criteria that match your payer mix — MassHealth routing discipline, behavioral health coding depth, real denial and A/R work, and a pricing scope you can verify.
Looking for a more reliable medical billing partner? Fastora Medical Billing Solutions provides medical billing and revenue cycle management support for Massachusetts practices. Request your free initial billing audit to discuss your practice’s billing workflow and identify potential areas for improvement.
Sources: service descriptions are drawn from each company’s own published materials (New England Medical Billing, Boston Billing Solutions, Bradford Medical Associates, Billing Advantage, MediBillMD, athenahealth), reviewed October 2026. MassHealth program facts are drawn from Commonwealth of Massachusetts (mass.gov) program materials. Fastora company figures are company-reported.
