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Point32Health Payment Policy updates

Harvard Pilgrim Health Care·Psychiatry, Allergy & Immunology, Cardiology +1 more·Reimbursement
Effective date
Jun 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Point32Health has updated multiple payment policies effective June 1, 2026, with minor administrative changes across behavioral health, substance use disorder, allergy, cardiac, and ambulance services. Most updates are for clarity and accuracy, with some specific coding additions for behavioral health services and modifier requirements.

Action Required

Action needed
Before June 1, 2026: Billing team must review updated Point32Health payment policies on their provider website. For behavioral health billing, update systems to include new revenue codes for intermediate services and intern-level modifiers with MHPRR modifier requirements. Remove prior authorization requirements for PASS services for RITogether members. Update coding for Individualized Treatment and Stabilization services.