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MedicaidBilling CodesHigh impact

Billing update for PACT services

Harvard Pilgrim Health Care·MA · Psychiatry·Reimbursement
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Point32Health has updated billing instructions for PACT (Program of Assertive Community Treatment) services, expanding coverage to Senior Care Options members and changing modifier requirements. 50-slot programs now use U1 modifier instead of previous coding, and 80-slot programs use U2 modifier instead of HT modifier.

Action Required

Action needed
Immediately: Update billing system to use correct modifiers for PACT services - H0040 U1 for 50-slot programs and H0040 U2 for 80-slot programs (replacing HT modifier). Forensic programs continue using H0040-H9. Train billing staff on new modifier requirements and update encounter forms. Verify system can process U1 and U2 modifiers before submitting claims.

Affected Billing Codes

H0040