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CommercialBilling CodesHigh impact

Laboratory Payment Policies: June 1, 2026 updates

Harvard Pilgrim Health Care·Family Medicine, Internal Medicine, OB-GYN +5 more·Reimbursement
Effective date
Jun 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

Point32Health (Harvard Pilgrim) is implementing extensive CPT code changes across multiple laboratory policies effective June 1, 2026, including removing 23 codes and adding 24 new codes across 11 different lab testing categories. A new prenatal testing policy for fetal aneuploidy is also being introduced.

Action Required

Action needed
By May 31, 2026: Billing team must update billing software and encounter forms to remove 23 discontinued CPT codes and add 24 new CPT codes for Harvard Pilgrim Commercial members. Review the new Laboratory: Prenatal Testing for Fetal Aneuploidy policy on the Point32Health provider website. Claims using removed codes after June 1, 2026 will be subject to automated edits and potential denial.

Affected Billing Codes

87880
86581
82233
82234
83884
84393
84394
87626
87661
87808
82565
82575
84702
84703
86701
86702
86703
86705
86803
86804
87660
G0432
G0433
G0435
G0472
G0475
S3645
87800
88341
88342
87149
87550
87555
87560
87564
83630
87164
87166