MedicaidAdministrativeMedium impact
New - interim billing for medical inpatient stays
Harvard Pilgrim Health Care·Reimbursement
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Point32Health now accepts interim billing for extended medical inpatient stays for Tufts Health Together, Tufts Health One Care, and Tufts Health Plan Senior Care Options members. Providers can submit cumulative bills every 60 days for admissions on or after July 1, 2024, instead of waiting for discharge.
Action Required
Immediately: Billing team must update system to enable interim billing for extended Tufts inpatient stays admitted on/after July 1, 2024. Use bill type 112 for initial interim bills (first 60 days) and bill type 117 for subsequent 60-day interval bills. Each bill must be cumulative of all services provided. Do not use bill types 113 or 114. Update billing workflows to submit claims every 60 days for extended stays rather than waiting for discharge.