CommercialReimbursementMedium impact
Fee schedule updates in effect April 1
Harvard Pilgrim Health Care·Reimbursement
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Point32Health (Harvard Pilgrim Health Care and Tufts Health Plan) will implement updated fee schedules effective April 1, 2026, for commercial professional services and behavioral health services. CMS has delayed laboratory code updates until 2027, so no additional fee schedule changes will occur in 2026.
Action Required
Before April 1, 2026: Billing team must update fee schedules in billing system for Point32Health plans (Harvard Pilgrim Commercial and Tufts Health Plan behavioral health services). Contact Point32Health or check provider portal for new fee schedule rates. Update contracts and expected reimbursement amounts in practice management system.