Medicare AdvantageReimbursementMedium impact
Point32Health Payment Policy updates
Harvard Pilgrim Health Care·OB-GYN, Family Medicine, General Practice·Reimbursement
Effective date
Mar 1, 2026
We identified it
Jun 20, 2026
Summary
Point32Health is implementing four payment policy updates affecting multiple Tufts Health and Harvard Pilgrim plans. Key changes include updated billing guidance for HCPCS T1015 for midwife/OB-GYN services at community health centers, new maximum unit limits based on CMS/Medicaid standards, and policy template transfers between Harvard Pilgrim and Point32Health systems.
Action Required
By March 1, 2026: Review and update billing procedures for HCPCS code T1015 (All-Inclusive Clinic Visit) to align with new state guidance for Certified Nurse Midwife and OB/GYN services at Community Health Centers for Tufts Health Together, Senior Care Options, and One Care plans. By May 1, 2026: Verify billing system reflects updated maximum unit values per CMS/Medicaid standards for all affected Tufts plans. Access Point32Health provider website for detailed policy requirements.