CommercialBilling CodesHigh impact
Laboratory Payment Policies: Dec. 1, 2026 updates
Harvard Pilgrim Health Care·ME · Gastroenterology, Endocrinology, Infectious Disease +3 more·Reimbursement
Effective date
Dec 1, 2026
We identified it
Oct 2, 2026
Summary
Point32Health/Harvard Pilgrim Health Care is adding new CPT codes to four laboratory testing policies effective December 1, 2026. Billing teams must update their systems to recognize and process these newly covered codes: 0421U for colorectal cancer screening, 82950 for diabetes testing, 87638 for microorganism identification, and 87627, 0600U, 0601U, and 0610U for pathogen panel testing.
Action Required
By November 30, 2026: Billing team must update the billing system and claims processing software to recognize and properly route the seven new CPT codes (0421U, 82950, 87638, 87627, 0600U, 0601U, 0610U) under their respective laboratory policies. Coordinate with laboratory and provider staff to communicate code changes. Update claim submission templates and billing software validation rules. Verify that claims submitted on or after December 1, 2026 with these codes are not rejected as invalid or unrecognized. Failure to implement these changes will result in claim denials and payment delays for laboratory services.