MedicaidAdministrativeMedium impact
Clinical Stabilization Services notification update
Harvard Pilgrim Health Care·Psychiatry·Provider Newsletter
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Effective January 1, 2026, providers offering clinical stabilization services (ASAM Level 3.5) must submit admission notifications within 72 hours instead of the current 11-day timeframe for specific Tufts Health plan members. This change aligns notification requirements with acute treatment services and aims to streamline behavioral health utilization management.
Action Required
Before January 1, 2026: Billing and administrative teams must update notification workflows for ASAM Level 3.5 clinical stabilization services to ensure admission notifications are submitted within 72 hours (reduced from 11 days) for Tufts Health Together, Tufts Health Direct, Tufts Health Plan Senior Care Options, and Tufts Health One Care members. Submit notifications through the Tufts Health Plan secure portal or complete the Behavioral Health Notification Form. Update internal tracking systems to monitor the new 72-hour deadline to ensure compliance and prevent potential payment delays.