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Point32Health Payment Policy updates

Harvard Pilgrim Health Care·Reimbursement
Effective date
May 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Point32Health updated 11 payment policies with minor administrative changes for accuracy and clarity, affecting multiple services including acupuncture, newborn care, urgent care, and ABA services. One notable change removes references to a discontinued Medicaid product (Tufts Health Plan Senior Care Options SCO Medi) from the All-Inclusive Clinic Visit policy.

Action Required

Action needed
Before May 1, 2026: Billing team should review updated Point32Health payment policies on their provider website for any specific changes that may affect billing practices. Verify that T1015 billing for All-Inclusive Clinic Visits is updated to reflect removal of the discontinued SCO Medi product references.

Affected Billing Codes

T1015