High impact
Point32Health Payment Policy updates
Harvard Pilgrim Health Care·Effective Jul 1, 2026
Point32Health issued multiple payment policy updates effective 7/1/2026 affecting eight service categories across Harvard Pilgrim and Tufts Health plans. Most updates are minor administrative clarifications, but two require immediate billing changes: (1) Behavioral Health now prohibits billing psychological test codes (96130-96131) and neuropsychological test codes (96132-96133) together in the same episode of care—providers must select only the predominant service code; (2) Obstetrics/Gynecology (Tufts Health RITogether only) now allows doula service billing using specific HCPCS codes (S9445, S9446, 59510, 59400) with modifiers instead of S9445 alone.